# Paraphimosis Reduction

## Overview

This module describes how to reduce a paraphimosis, or entrapment of the foreskin in the retracted position.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“Your foreskin has become stuck behind the swollen head of your penis. If we don’t treat it, the head of your penis will not get enough blood supply, which could endanger it. That is why I need to urgently get the foreskin back into place.”

### What can my patient expect?

“If it is necessary, I can give you an injection for pain, as this procedure can sometimes be painful. I will apply pressure to the head of your penis to reduce the swelling, then I will try to pull the foreskin over the head of the penis. I may try a few other techniques, like putting your penis in a solution which reduces swelling. If all else fails, I will call a senior colleague who can make a small cut in the foreskin to release it.”

### What is my patient’s role?

“Let me know if you have any allergies. Fearing blood or needles is normal, but tell me if you have fainted from it. Tell me if the pain is too severe and we can try the injection. Try to stay calm.”

## Preparation

Prepare a trolley with equipment.

### Documentation

### Equipment

## Site & Positioning

Position the patient supine.

## Procedure

Follow medical asepsis with sterile gloves.

## Troubleshooting

I cannot reduce the paraphimosis.

If these noninvasive techniques fail, a dorsal slit procedure may need to be performed by a urologist or senior colleague.

I want to prevent paraphimosis from recurring.

Patients with reduced paraphimosis should have an elective dorsal slit procedure or circumcision 6 weeks after reduction.

## Risks

## References