PARAFIMOZ

Paraphimosis - infringement of a head of a sexual member narrowed by an extreme flesh. It occurs, as a rule, in children with masturbation, against a background of physiological or moderate cicatricial narrowing of the foreskin; In adults is possible with sexual intercourse.

The clinical picture is caused by the infringement of the head of the penis with narrowed foreskin, violation of blood and lymph circulation of the glans penis and foreskin, which develop rather quickly and are accompanied by significant edema, pain, difficulty urinating. Palpation is painful. With prolonged paraphimosis, skin ulceration of the glans penis and even necrosis is possible.

The therapeutic tactics depends mainly on the duration of the infringement and the degree of trophic changes in the tissues. In the next few hours after the infringement, attempts at conservative restoration are justified. The head of the penis and the skin of the foreskin is treated with antiseptic solutions and sterile vaseline oil, and then, by prolonged, gradual and careful squeezing of the head with fingers, reduce its size and try to push through the restraining ring into the prepuce bag. In children, it is desirable to perform manipulation under general anesthesia, in adults it can be performed under local anesthesia with a 0.5% solution of novocaine, which is injected under the skin at the base of the penis.

In the case of a prolonged infringement and the impossibility of restoring the head of the penis, resort to an operative intervention, which consists in dissecting the restraining ring. After the acute inflammatory process subsides, the foreskin is cut off.