Paraphimosis repair

An acute complication of phimosis is paraphimosis, a condition that requires immediate assistance. The head of the penis, pinched by the foreskin, quickly swells without proper intervention, and necrotic processes develop. In order to avoid negative consequences, it is necessary to have a clear idea of how to correct paraphimosis. If such assistance is provided quickly and efficiently, many problems for men's health can be avoided.

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Indications for the procedure

Paraphimosis is considered one of the complications of phimosis and occurs against the background of its second or third degree. In some cases, the fact of strangulation occurs without complete blockage of blood supply, but compression of the urethral canal is always present.

Reduction of paraphimosis should be started immediately as soon as the following symptoms of acute complications are detected:

• acute sudden pain in the head of the penis (less often it intensifies, gradually increasing, but still appears sharply);
• increasing swelling of the penis (the rounded ridge along the coronal groove is especially prominent and swollen);
• ischemic processes in the distal or terminal portion of the penis, which are accompanied by darkening or bluish discoloration of the skin;
• a forced position of a person to relieve pain (the victim, as a rule, spreads his legs to the sides and leans forward as much as possible);
• urination is very difficult or impossible.

The painful symptoms presented above are an indication for immediate measures to correct paraphimosis.

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Preparation

Since the reduction of paraphimosis is an emergency procedure, no special preparation is required: it is important to carry out the procedure as soon as possible. If possible, the head of the penis is treated with vegetable or Vaseline oil, or baby cream, or plain water. Again, if necessary and possible, anesthesia is administered. But, since every minute counts with paraphimosis, the reduction is carried out even in the absence of oils, creams, and other means.

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Technique paraphimosis repair

Paraphimosis reduction can sometimes be done independently: this should be done immediately - the sooner the better. If you correct the problem in 1-2 minutes, you can avoid swelling and severe pain.

To increase the effectiveness of the procedure and relieve pain, apply a little Vaseline or vegetable oil, or baby cream to the head of the penis. During the reduction process, the pain will increase, so you need to be prepared for this. If you are unable to reduce the paraphimosis within three or four minutes, it is better not to waste time and urgently contact a medical specialist. It should be taken into account that this condition is truly urgent, and even ten minutes is enough for necrotic damage to occur in the tissues of the head and foreskin.

A qualified reduction of paraphimosis can be performed by a surgeon using local anesthesia with novocaine or lidocaine. In case of paraphimosis in childhood, general anesthesia is sometimes required.

The doctor will first try to correct the problem manually: if there is no positive result, a minor surgical intervention is performed, the essence of which is to cut the foreskin with subsequent reduction of the head. In such a development of events, the patient will have to go through a recovery period with the use of non-steroidal anti-inflammatory drugs and local application of antimicrobial external agents. In addition, it is recommended to irrigate and wash the head with disinfectant solutions - for example, a weak solution of potassium permanganate or furacilin.

Manual reduction of paraphimosis is a one-time release of the strangulation: the head is pushed out through the strangulated ring, and the foreskin is returned to its original place. In most cases, this procedure is done without anesthesia, only sometimes it is necessary to resort to short-term methods of analgesia.

The technique of reduction is as follows:

• the victim is laid horizontally and fixed if necessary;
• the head with the foreskin is treated with Vaseline or vegetable oil;
• The person performing the paraphimosis reduction places the thumbs of the hands on the head of the penis and grasps the pinched ring with the others;
• Gently, without using excessive force, you should press on the head, trying to push it through the hole, after which you need to push the skin of the foreskin over it.

You cannot press on the head with sharp and energetic pushes. It is better to provide constant gentle pressure, which will help reduce swelling of the head and its free passage through the pinched ring.

After successful manual reduction of paraphimosis, the victim should rinse the penis with warm water and a weak solution of potassium permanganate, twice a day until the painful symptoms subside.

Contraindications to the procedure

Paraphimosis reduction is performed as soon as possible to prevent the development of tissue necrosis or gangrene. If necrotic processes have already developed, then further attempts at reduction are contraindicated: the victim must be hospitalized immediately. In the hospital, he will be given emergency surgical care.

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Consequences after the procedure

Reduction of paraphimosis is always necessary, as this condition is considered critical and has every chance of ending with unpleasant consequences. If measures are not taken in a timely manner, the patient can seriously harm his health and even lose the reproductive organ.

Compression of the head leads to a persistent disruption of the blood supply to the tissues. If the skin of the head has acquired a bluish, dark or purple color, this indicates the development of necrotic processes - simply put, tissue necrosis begins. The consequences of such processes are easy to guess: this is an operation to amputate the head or the entire organ. Such intervention is carried out in order to save the life of the victim: the question of preserving the organ in such a situation is no longer considered.

Necrotic changes can also develop with paraphimosis in childhood. Therefore, parents should not delay calling an ambulance under any circumstances.

Complications after the procedure

After successful reduction of paraphimosis, the patient may experience the following symptoms for some time:

• mild pain;
• slight swelling of the head of the organ;
• increasing penile sensitivity.

The listed symptoms are considered quite adequate: they will pass within a few days. However, if you ignore the doctor's advice and neglect the rules for caring for the genital organ after the reduction of paraphimosis, complications may develop in the form of the spread of infection.

You should see a doctor if you experience the following symptoms:

• the head became swollen, reddened, and painful;
• discharge appeared from the genitals;
• the penis is covered with bluish or brownish spots;
• the temperature rose, the general state of health worsened.

After paraphimosis reduction, complications occur quite rarely, but they should not be forgotten. Negative consequences can negatively affect not only a person's well-being, but also the possibility of further sexual activity.

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Care after the procedure

If manual reduction of paraphimosis is successful, the penis is given an elevated position, fixing it to the abdomen. This ensures the fastest possible removal of swelling. In the future, the patient is recommended to treat the penis twice a day with disinfectant solutions to avoid infection and the development of inflammatory processes. It is optimal to use a weak solution of potassium permanganate, furacilin for treating the organ.

• If necessary, the patient takes painkillers (analgin, ibuprofen, etc.).
• For two days the patient should rest, avoid active sports, do not run and walk less.
• You should follow all the doctor's advice regarding the treatment of the genitals.
• Sexual intercourse is prohibited until the organ tissue has fully recovered.
• If the patient experiences a painful erection during healing, an ice compress should be applied to the genitals to relieve the pain.
• If paraphimosis reduction was performed on a child, then during the recovery stage it is advisable to apply a bandage for some time.

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Reviews

Based on numerous reviews, one important conclusion can be made: with paraphimosis, the main thing is to act clearly and immediately, because such a problem is really urgent. Signs of necrosis can appear within ten minutes: tissue death begins, which will subsequently have to be removed surgically.

If the patient or his relatives cannot solve the problem independently and quickly, then there is no point in wasting time: it is better to call an ambulance as soon as possible and entrust the problem to a medical specialist. Timely reduction of paraphimosis allows eliminating the threat to the life and health of the victim, but this must be done within the first few minutes.