Monday, 25 April 2016

Medical notes (surgery)

Urology

Phymosis and paraphymosis

Phymosis.           Paraphymosis.
Inability to            Inability to pull
Retract the           Retracted
Prepuce                prepuce    
(Foreskin).            forward.

Phymosis

Etiology-
Congenital
Chronic balanophosthitis (inflammation of glans penis and prepuse)
Chancre (painless ulcer due to infection)
Carcinoma

Clinical features
Ballooning of penis
Can't retract the skin over penis (prepuce)
Might in turn lead to balanophosthitis

Complications
Ca penis
Paraphymosis

Treatment- circumcision.

Paraphymosis

Pathogenesis

The non retractable skin forms a ring and compresses veins (venous congestion), causing glans penis to swell.

Causes - after urinary catheterization, after sexual inter course.

Clinic features- pain, swelling and edema of prepuce and glans penis.

Treatment
Injection hydrluronidase (250 units) on the ring then after swelling subsides physical manipulation.
Circumcision later.

Complication - ulcer and gangrene.

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