Glans penis aspiration for reduction of paraphimosis

Penis aspiration is an invasive method for paraphimosis reduction and is usually performed by an urologist but can also be performed by a knowledgeable physician if no urologist is available and emergency reduction is needed (eg, glans penis necrosis or complete urinary obstruction). After local anesthesia and, in young children or otherwise uncooperative patients, procedural sedation are performed, a 20 gauge needle is attached to a 10 mL syringe and advanced parallel to the urethra as shown. After aspiration of blood, the foreskin is reduced over the decompressed glans penis similar to manual reduction (Refer to UpToDate topics on treatment of paraphimosis).