Clinical-Surgical Implications of Paraphimosis: A Narrative Review

Abstract

Paraphimosis is a urologic emergency that occurs in uncircumcised men when the foreskin is pinched behind the crown of the glans, forming a tight band of compressive tissue. Prison phimosis, which is often iatrogenic, can be prevented by replacing the foreskin with the glans penis after manipulation. Treatment usually begins with a reduction of edema, followed by a variety of options, including mechanical compression, drug therapy, puncture technique, and dorsal incision. Prevention and early intervention are key elements in the treatment of paraphimosis, as this topic is little discussed in academia. Methodology: This is an integrated literature review. Starting from the selection of the highly relevant topic for medical students, the research process includes the following steps: a selection of databases of academic-scientific impact and descriptors used to filter the data; developing inclusion and exclusion criteria for articles in this review and selecting articles that meet these criteria; organization of the selected elements; and, finally, presentation and analysis of the data obtained. The databases selected were PubMed Central (PMC) and Latin American and Caribbean Literature in Health Sciences (LILACS).Results: During the research, few articles were found that present relevant information on the topic addressed, which is to describe the pathophysiology of patients with paraphimosis and the evaluation of patients with paraphimosis. Review of conservative and surgical treatment options available for patients with paraphimosis Summarize interprofessional group strategies to improve coordination of care to facilitate rapid diagnosis and treatment of patients with paraphimosis. It is a worrying scenario since paraphimosis is a urological emergency, and we have few studies regarding these issues in academic society. The newly trained medical professionals are unable to make a rapid diagnosis and treat patients with paraphimosis. Conclusion: This review showed that, in the academic scenario, the importance of more study and publication of articles on paraphimosis, knowing how to diagnose quickly and start the most efficient treatment, brings the patient a greater resolution of his acute condition of strangulation of his glans, avoiding necrosis. Therefore, future studies should focus on discussing whether mainly medical students and newly graduated doctors have adequate knowledge, including the patient's medical clinic, pathophysiology, best diagnosis, and conservative and surgical treatment available for patients with paraphimosis."Each of us, however old we may be, is still an apprentice in the school of experience. When a man believes he has graduated, he becomes a public menace."(John Chalmer da Costa, M.D.)