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.