Hello everyone and welcome back to EM Clerkship. Today's deep dive is going to cover

paraphimosis, which is what I like to call an appendage-threatening emergency that we must be

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www.personravitz.com. All right, so let's get into the deep dive. This month's case was a case

of penile swelling. Before we narrow in specifically on paraphimosis, I want to go

through a differential for penile swelling. The other main emergent condition that you must know

is preopism, which is a maintained erection of the penis. Within the category of preepism,

there is both low flow and high flow preapism.

Low flow preepism involves venous outflow obstruction, which is caused by impaired relaxation

of the cavernosal smooth muscle, which is the classic cause of your medication-related preepism.

Now, high flow preepism is more likely to be due to an arterial injury from causes

like trauma to the groin. Additional causes of penile swelling include infectious causes like a cellulitis

or a sexually transmitted infection. There's also balinitis and balinoposthitis. Balinitis is inflammatory change of just the

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