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Paraphimosis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • The entrapment of the retracted foreskin proximal to the glans of the penis

  • Leads to lymphatic congestion and venous obstruction, which may result in arterial compromise to the glans

  • P...

Diagnosis

Signs and Symptoms

  • Retracted prepuce (foreskin)

  • Pain

  • Swollen, edematous glans

  • Local cellulitis

  • Necrosis of glans in untreated cases

Physical Exam

Exam of the genitalia should include a search for c...

Treatment

Pre-Hospital

  • Patients should be transported promptly; do not attempt reduction in the field.

  • Pre-hospital personnel can be advised to apply an ice pack to the glans with adequate protection of...

Follow-Up

Disposition

Admission Criteria

Necrosis or cellulitis of the penis 

Discharge Criteria

  • Successful reduction with relief of symptoms

  • Close urologic follow-up

Issues for Referral

  • Urologic consultatio...

Pearls and Pitfalls

  • Goal is to reduce penile edema enough to allow the foreskin to return to original position over the glans.

  • Generally, noninvasive reduction methods (at least 2 or 3 attempts) are su...

Additional Reading

Codes

ICD9

605 Redundant prepuce and phimosis 

ICD10

N47.2 Paraphimosis 

SNOMED

  • 13758004 paraphimosis (disorder)

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