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Modified puncture technique for reduction of paraphymosis
1Department of Urology, Leighton Hospital, Crewe, Cheshire, UK. vkumar3908@hotmail.com
Annals of the Royal College of Surgeons of England
|April 26, 2001
Summary
The multiple puncture and glans squeeze technique effectively reduces paraphymosis (painful entrapment of the foreskin) in most cases. This method is successful for grades 1 and 2, but grade 3 paraphymosis may require surgical intervention.
Area of Science:
- Urology
- Surgical Techniques
Background:
- Paraphymosis, the inability to return the forescalp to its normal position, is a common urological emergency.
- Prompt reduction is crucial to prevent glans ischemia and tissue damage.
Purpose of the Study:
- To evaluate the efficacy of the multiple puncture and glans squeeze technique for paraphymosis reduction.
- To assess the technique's success rates across different grades of paraphymosis.
Main Methods:
- A total of 45 patients with paraphymosis were treated using the multiple puncture and glans squeeze technique.
- Patients were classified into three grades based on the severity of engorgement and associated skin changes.
- Data were collected from August 1991 to September 1999 across two hospitals.
Main Results:
- Grade 1 paraphymosis (no engorgement) was resolved by manual repositioning.
- The multiple puncture and glans squeeze technique successfully reduced paraphymosis in 37 out of 45 patients (Grade 2).
- Two patients (Grade 3) with significant skin changes required surgical division of the constricting band.
Conclusions:
- The multiple puncture and glans squeeze technique is a highly effective method for reducing paraphymosis, particularly in cases without severe skin changes.
- For difficult paraphymosis with gross glans engorgement, this technique offers a successful non-surgical option.
- Surgical intervention may be necessary for advanced cases of paraphymosis with marked skin alterations.