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Paraphimosis Pain Treatment with Nebulized Ketamine in the Emergency Department. Paraphimosis is an acute urological emergency occurring in uncircumcised males that can lead to strangulation of the glans and painful vascular compromise. Ketamine has been used in the emergency department (ED) as an anesthetic agent for procedural sedation, and when administrated in a sub-dissociative dose (low dose) at 0.1-0.3 mg/kg, ketamine has been utilized in the ED and prehospital settings for pain control as an adjunct and as an alternative to opioid, as well as for preprocedural sedation. This report details the case of a pediatric patient who presented to our Pediatric ED with paraphimosis and had his procedural pain treated with ketamine administrated via a breath-actuated nebulizer (BAN
Phimosis and Paraphimosis We value your privacyWe and our partners store and/or access information on a device, such as cookies and process personal data, such as unique identifiers and standard information sent by a device for personalised ads and content, ad and content measurement, and audience insights, as well as to develop and improve products. With your permission we and our partners may obliterans may require not just circumcision but dilatation of the urethral meatus or meatoplasty.There is no evidence that smegma is a carcinogen and the association between smegma accumulation and penile carcinoma may be due to associated infection[3].Paraphimosis[7]This occurs when a tight prepuce is retracted and then unable to be replaced as the glans swells. This is a urological emergency. Always
Comparison of outcomes for pediatric paraphimosis reduction using topical anesthetic versus intravenous procedural sedation. Paraphimosis is an acute urologic emergency requiring urgent manual reduction, frequently necessitating procedural sedation (PS) in the pediatric population. The present study sought to compare outcomes among pediatric patients undergoing paraphimosis reduction using a novel topical anesthetic (TA) technique versus PS. We performed a retrospective analysis of all patients <18years old, presenting to a tertiary pediatric ED requiring analgesia for paraphimosis reduction between October 2013 and September 2016. The primary outcome was reduction first attempt success; secondary outcomes included Emergency Department length of stay (ED LOS), adverse events and return
Ultrasound-guided dorsal penile nerve block for ED paraphimosis reduction. Adequate anesthesia for emergency department management of painful penile conditions such as paraphimosis or priapism is often both technically challenging and inconsistent using traditional landmark-based techniques of the dorsal penile block (DPB). The pudendal nerves branch to form the paired dorsal nerves of the penis ultrasound, the dorsal penile nerves can be precisely targeted in the fascial compartment just deep to Buck fascia, potentially increasing block success rate and reducing the need for large local anesthetic volumes. Herein, we report the first adult case of an ultrasound-guided dorsal penile nerve block performed in the emergency department for the reduction of a paraphimosis and review the relevant penile
than 3 years of age, and may be a normal finding up until the age of puberty. Acquired (pathologic) phimosis is the inability to retract the foreskin proximally over the glans penis in post-pubertal males, or in patients in whom scarring has developed from chronic infection and inflammation (balanoposthitis), or as a result of repeated forced retraction of congenital phimosis. Paraphimosis (paraphimosis) * indwelling urinary catheter (paraphimosis) * parental unawareness (phimosis) * balanitis xerotica obliterans (phimosis) * penile trauma (phimosis) * recurrent balanitis and balanoposthitis (phimosis) * low birth weight (hypospadias) * premature delivery (hypospadias) * gestational diabetes, maternal obesity, maternal hypertension, older maternal age (hypospadias) * family history (hypospadias
performed during surgery for benign indications in a population at low risk for ovarian cancer. The results of a histopathologic analysis of foreskin specimens rarely have an impact on patient management. Common indications for circumcision are phimosis, paraphimosis and balanitis xerotica obliterans (BXO). Studies have shown that in more than 83% of cases of lichen sclerosus, the diagnosis was suspected