acute

Genital injury (including circumcision)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

MSF Essential Drugs 2024 - paracetamol (oral) · Tullington JE, Blecker N. Lower Genitourinary Trauma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- . [Updated 2023 May 8]. Bookshelf ID: NBK557527. PMID: 32491459.

Verified against1 document

MSF Essential Drugs 2024 - paracetamol (oral)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

Blunt scrotal trauma: severe pain, swelling that comes on fast, and nausea [nausea]
Penile fracture: the patient describes a sudden bend, a snap or pop, sharp pain, and instant loss of erection
Urethral injury: inability to pass urine, or a sense of suprapubic fullness
Visible blood in the urine points towards a genitourinary injury [blood in the urine]
Men with penile fracture often come late because they are embarrassed

Signs — what you find (9)

Urethral injury: blood at the meatus, perineal bruising or tear, scrotal haematoma, a prostate riding high on rectal exam, or a catheter that will not pass [bruising · hematoma]
A perineal haematoma should raise concern about injury to pelvic organs including the urinary tract [hematoma]
Gross blood found on rectal examination indicates bowel injury
Any instability of the pelvis on examination means there is a fracture
Penile fracture: swollen, bruised penis that leans away from the side of the tear
Swelling held within Buck fascia gives the eggplant deformity of the penis [visible deformity]
Bruising is inconsistent, and haematoma size does not track how badly the testis is injured [bruising · hematoma]
Pain and a scrotal hematocele, blood and fluid in the tunica vaginalis, often limit examination
Female genital trauma: bruising, swelling or tears of the vulva, and lacerations or impalement seen on speculum exam [bruising]

Tests (9)

Retrograde urethrogram is indicated whenever urethral injury is suspected
Cystography, plain or CT, is the first-line imaging for a suspected bladder injury, and contrast seen outside the bladder confirms it
Gross haematuria with a pelvic fracture or blunt trauma is an absolute indication to evaluate the lower urinary tract
Scrotal ultrasound comes first for suspected testicular rupture, reported at 100% sensitivity and 93.5% specificity
Ultrasound features of a ruptured testis: patchy parenchymal echotexture and a break in the tunica albuginea
Penile fracture needs no imaging when history and examination fit; ultrasound is used if the picture is unclear, MRI if still equivocal
A raised serum lactate, with a base deficit on arterial gas, flags bleeding; the first haemoglobin and haematocrit miss it
FAST scanning shows free fluid but cannot tell blood from bowel contents
On contrast CT an arterial-phase blush means active arterial bleeding, and the delayed phase reveals urinary tract injury

If not this — what else fits (10)

Renal injury
Ureter injury
Pelvic fracture
Rectal injury
Vaginal laceration
Abdominal injury
Retroperitoneal haemorrhage
Urethral stenosis
Urinary calculi
Fournier gangrene

SourceStatPearls "Lower Genitourinary Trauma" - disease-level clinical article

Presentation findings are traced to the source above.

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever

Paediatric dose

15 mg/kg/dose [child max 500 mg]

(Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.)

Dose by weight
3kg	45 mg/dose
4kg	60 mg/dose
5kg	75 mg/dose
6kg	90 mg/dose
7kg	105 mg/dose
8kg	120 mg/dose
9kg	135 mg/dose
10kg	150 mg/dose
11kg	165 mg/dose
12kg	180 mg/dose
13kg	195 mg/dose
14kg	210 mg/dose
15kg	225 mg/dose
16kg	240 mg/dose
17kg	255 mg/dose
18kg	270 mg/dose
19kg	285 mg/dose
20kg	300 mg/dose
21kg	315 mg/dose
22kg	330 mg/dose
23kg	345 mg/dose
24kg	360 mg/dose
25kg	375 mg/dose
26kg	390 mg/dose
27kg	405 mg/dose
28kg	420 mg/dose
29kg	435 mg/dose
30kg	450 mg/dose
31kg	465 mg/dose
32kg	480 mg/dose
33kg	495 mg/dose
34kg	500 mg/dose (capped)
35kg	500 mg/dose (capped)
36kg	500 mg/dose (capped)
37kg	500 mg/dose (capped)
38kg	500 mg/dose (capped)
39kg	500 mg/dose (capped)
40kg	500 mg/dose (capped)
41kg	500 mg/dose (capped)
42kg	500 mg/dose (capped)
43kg	500 mg/dose (capped)
44kg	500 mg/dose (capped)
45kg	500 mg/dose (capped)
46kg	500 mg/dose (capped)
47kg	500 mg/dose (capped)
48kg	500 mg/dose (capped)
49kg	500 mg/dose (capped)
50kg	500 mg/dose (capped)

Dose source

MSF Essential Drugs 2024 - paracetamol (oral)

Why

Standard analgesic dose for post-procedural or minor genital trauma pain; dosing is unchanged by the cause of the pain.

Cautions

Simple analgesic for post-circumcision or minor genital injury pain.
Refer urgently for heavy or uncontrolled bleeding, inability to urinate after circumcision, signs of wound infection or fever, or suspected penile fracture/testicular rupture - paracetamol is for pain control only, not a substitute for surgical assessment when red flags are present.
Do not exceed 4 g in 24 hours.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
FEBRIMOL 500 MG 20 TAB.	PHARCO	3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.	MEMPHIS	8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.	MUP	13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.	EIPICO	24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.	UTOPIA	42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.	MISR	38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETS	JULPHAR	32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETS	AUG PHARMA	50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solid	PHARCO	4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solid	PHAROPHARMA	5.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.