|Minor Surgical Procedures in Remote Areas (MSF, 1989, 172 p.)|
|Chapter 5: uro-genital procedures|
Acute swelling of the retracted prepuce.
Urgent treatment is required to prevent glans necrosis
· It is almost always possible to reduce manually, without anesthesia, depending on the condition of the patient. Light sedation with diazepam is sometimes necessary.
· Compress the glans with the fingers of the left hand, while holding the shaft of the penis with the other hand.
· Daily baths with a solution of chlorhexidine (+ cetrimide) (See table page 7).
· Often, manual reduction is difficult or impossible.
· Place an incision in the axis of the penis on the dorsal surface (the urethra is situated on the ventral surface).
· Incise the two rolls of prepucial skin as far as the deep ligament which is constricting the penis.
· The reduction will then be easy.
· A circumcision is recommanded a few weeks later.