Paraphimosis

When the tight foreskin is retracted, it may sometimes be difficult to return and a paraphimosis results. In this condi­tion, the venous and lymphatic return from the glans and distal foreskin is obstructed and these structure swell alarmingly causing even more pressure within the obstructing ring of prepuce. ice bags, gentle manual compression and injection of a solution of hyaluronidase in normal saline may help to reduce the swelling. Such patients can be treated by circumcision if careful manipulation fails. A dorsal slit of the prepuce under local anaesthetic may be enough in an emergency.