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close this bookMinor Surgical Procedures in Remote Areas (MSF, 1989, 172 p.)
close this folderChapter 5: uro-genital procedures
View the documentUrinary catheterisation
View the documentReduction of a paraphymosis
View the documentEpisiotomy
View the documentSuturing episiotomies or perineal tears
View the documentIntra-uterine procedures
View the documentTreatment of a bartholin abscess

Reduction of a paraphymosis

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.