Hyaluronidase as an Aid to Correction of Paraphimosis
PARAPHIMOSIS is a condition in which the prepuce becomes displaced and fixed behind the glans penis. It is often painful. It is almost invariably associated with a tight preputial margin that acts as a constricting ring when it retracts behind the glans; this often occurs during sexual intercourse. The constriction soon creates a “doughnut-like” ring of edema interposed between the constricting band and the glans penis which prevents replacement of the prepuce to its normal position covering the glans.
In those few patients who are seen before the edema becomes too extensive, it is possible to replace the prepuce by manually compressing the edema and then “rolling” the prepuce over the collar of edema. When this is unsuccessful, we have heretofore had to resort to surgical correction by means of a dorsal slit which divides the constricting preputial band.
Williams and Nichols1 in 1952 reported the use of hyaluronidase in reducing paraphimosis in three patients; more recently my attention was drawn to this useful procedure by Ratliff2 who reported a case similarly treated. I have recently utilized this method of treatment in one patient and the result was most gratifying. This case is described here in order to disseminate information regarding this useful procedure; it is hoped this may benefit others who may be called upon to treat those afflicted with this benign though painful condition.
A man, 23 years of age, was referred to me because of a painful swelling of the penis. Examination revealed a typical . . .