Is a concentrated sugar solution better than granulated sugar to reduce paraphimosis?

Report By: Mr. T K George - Consultant in Emergency Medicine
Search checked by Zia Hassan - SpR in Emergency Medicine
Institution: Blackburn Royal Infirmary
Date Submitted: 16th January 2006
Last Modified: 2nd March 2006
Status: Blue (submitted but not checked)

Three Part Question

In [young male with irreducible paraphimosis] is [50% dextrose water better than granulated sugar] at [reducing swelling and allowing reduction]?

Clinical Scenario

26 year old male presented to the Emergency department with a two days history of paraphimosis. Rather than using granulated sugar the local practice is to make the patient soak his in a paper cup containing 50 ml of 50% dextrose water for approximately 20 minutes. This appeared to be easy and straightforward with a successful outcome. You wonder therefore whether there is any evidence showing concentrated sugar solution being better than granulated sugar in reducing a paraphimosis.

Search Strategy

Medline 1966-11/05 using the OVID interface
[ paraphymosis. mp OR paraphimosis.mp OR exp. Paraphimosis OR (50% dextrose water.mp.AND granulated sugar.mp)] AND [ Reduc$.mp OR sugar.mp]
Medline 1966-11/05 using the OVID interface
[ paraphymosis. mp OR paraphimosis.mp OR exp. Paraphimosis OR (50% dextrose water.mp.AND granulated sugar.mp)] AND [ Reduc$.mp OR sugar.mp]

Search Outcome

Altogether 21 papers were found by the Medline search. No papers were directly relevant to the three part question

Comment(s)

There are no comparative or randomised trials in this area. Further research is warranted.

Clinical Bottom Line

There is no evidence to show whether concentrated sugar solution or granulated sugar is better in reducing a paraphimosis. Local practise should be followed.