A child presents with a retracted foreskin that has become trapped behind the glans penis and cannot be returned to its normal position. This condition is known as:

Appeared in: NORCET-11 Prelims

Explanation

Paraphimosis is when the retracted foreskin becomes trapped behind the glans penis and cannot be returned to its normal position.
This leads to painful venous stasis, swelling, and potential compromise of blood flow to the glans.
It is a urologic emergency because prolonged constriction can cause ischemia and necrosis of the glans penis.
Immediate intervention is required to reduce the foreskin and restore normal circulation.

Option A: Phimosis is the inability to retract the foreskin over the glans penis, not a trapped retracted foreskin.
Option C: Balanoposthitis is inflammation of the glans and foreskin, usually due to infection, not mechanical trapping.
Option D: Peyronie's disease is a condition in adults involving fibrous plaques in the penis causing curvature, not related to foreskin position.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification and differentiation of penile foreskin disorders in children as background academic context rather than a clinical decision trigger.
Nurses must recognize paraphimosis as a urologic emergency to prevent permanent damage to the glans penis.
Prompt reduction of the foreskin and escalation to a physician or urologist is critical.
What if? If the foreskin could not be retracted at all, the diagnosis would be phimosis, not paraphimosis, and emergency intervention would not be required unless there is urinary obstruction or infection.

How to Approach the Question

Identify the key clinical feature: retracted foreskin stuck behind the glans and cannot be returned.
Recall definitions of phimosis (cannot retract) and paraphimosis (cannot return after retraction).
Eliminate options that describe inflammation or unrelated adult conditions.
Choose the option that matches the emergency scenario described.

Concept Tested & Keywords

Concept Tested: Identification and differentiation of penile foreskin disorders in children
Stem keywords: child, retracted foreskin, trapped behind glans penis, cannot be returned
Lead-in keywords: condition is known as
Clinical cues: retracted foreskin stuck behind glans
Clinical cues: cannot return to normal position

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1100-1102

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