- Remove any foreign bodies or constricting bands.
|
- Inspect the penis for signs of glans penis necrosis (blue/black color and firmness to palpation).
|
- If necrosis or urinary obstruction is present, obtain emergency consultation with a urologist or surgeon with similar expertise and prepare for immediate reduction utilizing procedural sedation in the ED or general anesthesia in the OR.
|
- If glans penis necrosis is not present (glans penis is pink and soft), provide pain control (eg, topical or infiltrated local anesthetic), procedural sedation, as needed, and proceed with manual reduction:
- Apply methods to reduce swelling (ice, compression bandages, and/or osmotic agents).
- Ensure efficacy of chosen method of pain control.
- Perform manual reduction by providing manual circumferential compression for several minutes followed by manual reduction.
|
- If paraphimosis is still not reduced, consult a urologist or surgeon with similar expertise for reduction in the OR using regional anesthesia and/or general anesthesia.
|
