Summary
Definition
Paraphimosis is a condition caused when the foreskin of the uncircumcised penis is retracted and left behind the glans penis, leading to vascular engorgement and oedema of the distal glans.[1] This condition is a medical emergency when identified acutely and requires prompt, effective treatment to prevent loss of the distal glans penis.[2][3][Figure caption and citation for the preceding image starts]: Diagram illustrating paraphimosisFrom the collection of Dr Ranjiv Mathews [Citation ends].
História e exame físico
Principais fatores diagnósticos
- presence of risk factors
- penile pain
- band of retracted foreskin tissue beneath the glans
- swollen glans penis
- indwelling catheter
Outros fatores diagnósticos
- erythema
- black tissue on the glans
- non-pliable glans penis
- inability to urinate freely
Fatores de risco
- lack of circumcision
- urinary catheterisation
- dependence on a carer for daily hygiene
- tight foreskin
- phimosis
- poor hygiene
- bacterial infection
- parasitic infections
- lichen sclerosis
- diabetes
- penile piercing
- haemangiomas of the penis
- peripheral vascular disease
- inadequate circumcision
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical diagnosis
Algoritmo de tratamento
with ischaemia and necrosis
acute type without ischaemia and necrosis
chronic type without ischaemia and necrosis
Colaboradores
Autores
Ranjiv Mathews, MD
Associate Professor
Pediatric Urology
SIU School of Medicine
Springfield,
IL
Declarações
RM declares that he has no competing interests.
Revisores
Wesley Baas, MD
Assistant Professor of Urology
University of Cincinnati College of Medicine
Cincinnati
OH
Declarações
WB declares that he has no competing interests.
John Thomas, MD
Assistant Professor of Urologic Surgery
Division of Pediatric Urology
Monroe Carell Jr. Children's Hospital at Vanderbilt
Nashville
TN
Declarações
JT declares that he has no competing interests.
Vincent Gnanapragasam, MBBS, BMedSci, PhD, FRCSEng, FRCSEd(Urol)
Lecturer in Uro-oncology and Consultant Urological Surgeon
Department of Urology
Addenbrooke's Hospital
Cambridge
UK
Declarações
VG declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
European Association of Urology. Paediatric urology. March 2022 [internet publication].Texto completo
Manjunath AS, Hofer MD. Urologic emergencies. Med Clin North Am. 2018 Mar;102(2):373-85. Resumo
British Association of Paediatric Urologists. Management of foreskin conditions. 2017 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Allergic reactions
- Insect bites
- Tourniquet syndrome
Mais Diagnósticos diferenciaisDiretrizes
- Paediatric urology
- Management of foreskin conditions
Mais Diretrizes
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal