The treatment of paraphimosis involves reducing the penile edema and restoring the prepuce to its original position. There are no prospective, randomized, controlled studies comparing the efficacy of currently available treatment options. Several noninvasive or minimally invasive methods are used to reduce the penile swelling. Manual Reduction Manual pressure may reduce edema. A gloved hand is circled around the distal penis to apply circumferential pressure and disperse the edema.
Ice packs are also useful in reducing swelling of the penis and prepuce.
The penis is first wrapped in plastic, with ice packs applied intermittently until the swelling subsides. 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.