Puncture technique

The puncture technique (the Dundee technique) may be used after failed attempts at reduction using minimally invasive methods. After appropriate local analgesia and sedation as needed, the patient is prepped with antiseptic solution. Multiple punctures are then made in the edematous foreskin using a 25 gauge or smaller needle. Subsequently, the foreskin is reduced using manual compression and reduction (Refer to UpToDate topics on treatment of paraphimosis).