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Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
This patient may be suffering from a paraphimosis for which I would first consider risk factors such as tight foreskin, poor hygiene, previous infections and trauma to the penis. I would then enquire about penile pain, problems when retracting the foreskin and urinating. Upon examination, I would look for a band of retracted foreskin below the glans of the penis, and a swollen penile glans which often has an accompanying collar of oedematous foreskin. Finally, I would examine for erythema, exquisite pain and any red flag signs such as gangrene, necrosis and a non-pliable penis glans.
Neonatal and General paediatric Surgery
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Pathological phimosis rarely occurs before the age of 6 years. The foreskin is scarred and whitish in appearance and the opening is severely narrowed resulting in non-retractability (Fig. 18.80). During micturition there may be ballooning of the foreskin and dribbling may occur after voiding. Following an erection, the narrowed foreskin may remain around the glans, constricting its blood supply and culminate in a paraphimosis. The paraphimosis is an extremely painful swelling of the glans that requires emergency treatment either in reduction of the foreskin or a dorsal slit if reduction is not possible.
Paraphimosis
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
This patient has paraphimosis. Paraphimosis is a condition in which the foreskin is retracted behind the glans penis and becomes progressively edematous, leading to decreased blood flow to the glans. This is a medical emergency that requires reduction to preserve vascular supply to the glans. In contrast, phimosis is a medical condition where the foreskin is unable to be retracted over the glans. Although this latter condition often requires urologic follow-up, it is rarely associated with acute medical complications.
An evaluation of the pharmacotherapeutic options for the treatment of adult phimosis. A systematic review of the evidence
Published in Expert Opinion on Pharmacotherapy, 2022
Anna Lygas, Hrishikesh Bhaskar Joshi
Some indications to proceed with active treatment, in children, are recurrent urinary tract infections (UTIs), balanoposthitis and paraphimosis. Historically, the mainstream treatment of phimosis in children was surgery in a form of either circumcision or preputioplasty. The surgery caries number of risks and complications including local infection, hemorrhage, meatitis, and ulceration. For that reason, conservative treatment options have been explored as alternative to surgery.