Reduction of a paraphymosis

Acute swelling of the retracted prepuce.

Urgent treatment is required to prevent glans necrosis

Technique

Children

· 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).

Adult

· 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.

FIGURE