How is manual reduction performed in the treatment of paraphimosis?

Updated: Aug 05, 2017
  • Author: Hina Z Ghory, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Manual reduction is performed by placing both index fingers on the dorsal border of the penis behind the retracted prepuce and both thumbs on the end of the glans. The glans is pushed back through the prepuce with the help of constant thumb pressure while the index fingers pull the prepuce over the glans.

This technique may be facilitated by the use of ice and/or hand compression on the foreskin, glans, and penis to minimize edema of the glans prior to manual reduction. Soaking the penis in a glove full of ice for 5 minutes before attempting manual reduction has been reported to be effective 90% of the time. [20]

An elastic bandage can also be wrapped from the glans to the base of the penis for 5-7 minutes to minimize edema. [22]

Noncrushing clamps can be placed on the constricting portion of the foreskin at the 3- and 9-o'clock positions to apply gentle continuous symmetrical traction. [23] Also see, Paraphimosis Reduction.

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