Reduction of paraphimosis
McEvoy GK (Ed Hyaluronidase: chemistry and réduction internet orange stability,.
Subsequent circumcision is often unnecessary, but when it is required it can be done as an elective procedure which is technically easier, so allowing a good cosmetic outcome.
The remaining 12 patients had no evidence of phimosis and circumcision was unnecessary.
The oedematous prepuce (Fig.The commercially available enzyme is prepared from mammalian testes and is available as a lyophilized powder or as as stabilized clear solution or injection.3,4 Hyaluronidase acts by modifying the permeability of intercellular ground substance in connective tissue.From the Medical College of Georgia, Augusta, Georgia, Naval Medical Center, San Diego; and University of California, San Diego, Children's Hospital and Health Center, San Diego, California.Clinically, it has been used to enhance the effects of locally infiltrated toxins from intravenous sites.4 In paraphimosis, it immediately reduces preputial edema.Hamdy and Hastie 1 first reported the use of this technique to reduce A paraphimosis and we have shown that it can be successfully applied in A group of men many of whom have had A prolonged (more than 24 H) paraphimosis.Clark, LE, and Mellete JR: The use of hyaluronidase as an adjunct to surgical procedures.Barua2 1 Departments of Urology, The Churchill Hospital, Oxford,.Adverse effects are exceedingly rare4 Hyaluronidase is contraindicated in the presence of infection or cancer because it could facilitate the spread of bacteria or malignant cells.Br J Surg 1990; 77: 1186.The patients ranged in age from 8 to 81 years; the median (range) duration of paraphimosis was 48 (24-168) hrs.Harold Wood Hospital, Essex, UK, indications, the traditional treatment of paraphimosis which cannot be easily reduced is a dorsal slit followed by circumcision, either under the same anaesthetic or later, when the preputial oedema has resolved.We have used a simple "puncture" technique to treat successfully an uncircumcised 12-year-old boy with severe paraphimosis.This resulted in rapid diminution of the swelling, permitting easy manual reduction of the prepuce.1 A) was cleaned with an antiseptic cream.
The paraphimosis was reduced successfully in all patients, in 14 of them under local anaesthesia, and they were discharged from the Emergency Department.
Paraphimosis in uncircumcised or incompletely circumcised children is a serious and painful condition requiring prompt reduction to prevent possible necrosis of the glans or urinary obstruction.