To reduce edema, a compressive elastic dressing is then wrapped circumferentially around the penis from the glans to the base. Once the swelling has subsided, the wrap should be removed. To reduce edema, the penis is wrapped circumferentially with a compressive dressing from the glans to the base of the penis, and the dressing left in place for five to seven minutes. Pharmacologic Therapy Injection of hyaluronidase into the edematous prepuce is effective in resolving edema and allowing the foreskin to be easily reduced. 11 Degradation of hyaluronic acid by hyaluronidase enhances diffusion of trapped fluid between the tissue planes to decrease the preputial swelling.
Hyaluronidase is well suited for use in infants and children.
Granulated sugar is generously spread on the surface of the edematous prepuce and glans. The hypotonic fluid from the edematous prepuce travels down the osmotic gradient into the sugar, reducing the swelling and allowing for manual reduction. Both of the procedures mentioned here should be performed by a physician experienced in these techniques. Puncture sites permit safe and effective evacuation of the trapped fluid. External drainage of the trapped fluid allows for manual reduction of paraphimosis.