Children's Unit
 
SE/B06/017: Sweeten the swelling
 
Child on bed
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A 6 year old boy is brought to the emergency department by his mother. He has complained of penile pain from the previous evening, but when his mother examined him in the morning she noticed that the end of the penis was grossly swollen. He was still able to pass urine, but was getting increasing pain so she brought him to the ED.

On examination he has a paraphmosis with significant swelling to the glans and with marked oedema of the foreskin.

You attempt a manual reduction using lignocaine jelly, but it is too painful. You suggest ice, but it is too cold and her finds it very uncomfortable.

You wonder if there are any other ways of reducing the swelling, before you have to phone the surgeons.

Can you think of what else might be tried?

Click here for more ideas.
Link to a BestBet on paraphimosis