Version June 2024
| 1. Patients with hair tourniquet or other constricting bands have physical findings that are very similar to paraphimosis. |
| 2. Patients with glans penis ischemia with necrosis require emergent urologic consultation and preparation for invasive reduction utilizing procedural sedation in the ED or general anesthesia in the OR. |
| 3. Adequate pain control is essential for the cooperation necessary to achieve a successful reduction at the bedside. |
| 4. Most young boys are best served with procedural sedation for paraphimosis reduction. |
| 5. Methods to reduce swelling require a significant amount of time (eg, 30 to 60 minutes) to have an important impact on foreskin and glans penis swelling and should not be used when penile necrosis is evident. |
| 6. The compression time during a successful manual reduction of a paraphimosis often exceeds 5 minutes if adjuncts such as ice, compression bandages, or osmotic agents are not used. |
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