Painless paraphimosis: an urologic emergency case report in long-term care facilities

無痛性嵌頓性包莖：長照機構泌尿外科急症病例報告

梁鴻昌(Hung-Cheung Leung)；郭顯懋(Hsien-Mao Kuo)；林郁(Yu Lin)；阮祺文(Chi-Wen Juan)

paraphimosis ； tight constricting ring ； urinary outflow obstruction ； 嵌頓性包莖 ； 緊密收縮環 ； 尿路阻塞

中華職業醫學雜誌

27卷4期（2020 / 10 / 25）

295 - 299

英文

Paraphimosis is a urologic emergency. It is caused by the entrapment of a retracted prepuce behind the coronal sulcus. When trapped for a prolonged time, this results in a tight constricting ring of tissue formation causing vascular compromise and swelling of the glans, which prevents the retracted prepuce into its naturally occurring anatomic position. If left untreated, can lead to glans necrosis, tissue injury or urinary outflow obstruction. A patient with paraphimosis often presents with penile pain. We present a case of urinary tract infection due to painless paraphimosis with urinary outflow obstruction. Prevention and early intervention are key elements for paraphimosis in long-term care facilities.

嵌頓性包莖是一種泌尿外科急症。包皮被推至陰莖主體後不能恢復到其自然解剖位置，當長時間過緊的包皮卡住陰莖冠狀溝形成的緊密收縮環，會使包皮和龜頭因血液及淋巴液循環產生障礙，引致遠端包皮和龜頭腫脹及充血，如果不及時治療，可能導致龜頭壞死，組織損傷或尿流阻塞。嵌頓性包莖患者通常會出現陰莖痛。我們介紹了一例由於無痛性嵌頓性包莖導致尿路阻塞誘發泌尿道感染的病例。預防並盡早介入嵌頓性包莖處置是長照機構的關鍵因素。