Paraphimosis is entrapment of balanus by narrow prepuce. Narrowed prepuce can be moved behind the balanus with effort and leads to circular compression of the balanus. Sharp pain appears and there can be problems with urination. Balanus and prepuce edema grows on; balanus increases in size, and the latter disturbs hemodynamics to a greater extend.
It is a vicious circle: compression increases edema; and edema in its turn increases compression
Under prolonged entrapment, entrapment ring necrosis and partial balanus necrosis can develop (if not return prepuce in its place in proper time).
Treatment for paraphimosis can be either bloodless or surgical. Bloodless method implies manual reduction of balanus to entrapment ring. After vaselining balanus middle and point fingers of both hands tightly seize the penis below the entrapment ring. At the same time with the help of the thumb one tries to move balanus into the entrapment ring simultaneously pulling prepuce on it
If this turns out to be ineffective, it is necessary to cut the entrapment ring and remove prepuce behind the balanus.
If entrapment was caused by phimosis then it is preferable to perform circumcision (prepuce excision) in order to avoid repeated entrapments.
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