I struggled to find PEM resources for my CT3 year, despite the variety of excellent resources out there. I hope this website will help point you in the right direction. I'm not a PEM expert, but am following the guidance CEM have issued (in the form of a syllabus) to put together this page. This page is not endorsed by CEM, and any mistakes are mine.

Please comment with corrections, additions and further suggestions.

All the information here is collected from the internet, and it might be out of date or inaccurate, so please use your judgement and adhere to your hospital's protocols. If you do notice any errors or omissions please comment so we can put them right!

To navigate, decide whether you want to start with a PMP or a PAP. You can then select which PMP or PAP you want to look at. You will then be taken to the summary page for that PMP, with links expanded topic collections. If you know what topic you want to look at already, click on the link on the right hand side.

Friday, 8 May 2015

Penile Problems

Penile problems in children

Correct before 2 years of age. Do NOT circumcise as may need reconstructive surgery

- At 1 year old 50% boys have non-retractile foreskin, by 4yrs 10% and by 16yrs only 1%
- Non-retractile foreskin = balooning on micturition
- Topical corticosteroids can help.
- Encourage patients to maintain good hygiene and gently stretch the foreskin.

Emergency if causes acute urinary retention

Foreskin gets stuck in the retracted position.
Look for a hair tourniquet.
May be secondary to masturbation
Needs analgesia to reduce

Balanitis = cellulitis of the glans
Posthesis = cellulitis of the foreskin

Can be irritant, bacterial or fungal.

Needs warm baths
Rule out diabetes
Clotrimazole or antibiotic ointment
Normally get oral amox or trimeth too


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