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Paraphimosis

Definition: What is Paraphimosis?

This medical condition is when the foreskin of the penis cannot be returned to the original position. When this happens normally the foreskin is stuck behind the head of the penis. It only happens to uncircumcised males and is an uncommon occurrence. When it happens in newborn male babies it is referred to as physiologic paraphimosis and normally occurs naturally. This medical condition will eventually resolve on its own with no treatment as the child ages. If it occurs after puberty or after the foreskin has been retracted for several hours it becomes an emergency medical problem.


Symptoms

The symptoms of paraphimosis will normally happen after paraphimosis occurs or is just beginning. These can include:

  • Swelling of the head of the penis is the foreskin is left behind the penis longer than is necessary. If it starts to swell this could trap the foreskin behind it
  • If it becomes trapped then it starts to form a constricting ring that can lead to the accumulation of fluid called edema, in the penile head
  • When there is an accumulation of fluid it makes the penis look very swollen and red aside from being painful and soft
  • As the accumulation of fluid worsens the blood flow to the area is affected and can lead to severe pain and possible gangrene. When a person has gangrene it is the death of cells that is caused by the loss of the supply of blood to an area. If it happens in paraphimosis it can cause the head of the penis to appear firmer when touched and blue or black in color. At this point the condition is irreversible.

Causes of Paraphimosis

In males who are not circumcised it can be caused by the failure to pull the foreskin back after sexual intercourse or after cleaning, leaving the foreskin behind the head of their penis. Two other causes that could cause paraphimosis are having a thorough examination of their penis or having a catheter inserted. Ring piercings in the head of their penis could also lead to this medical condition but this is rare.

Treatment

When a man first notices paraphimosis is occurring they should seek immediate medical treatment. What treatment is used will depend on how severe the condition is. If it has reached the stage of gangrene the only medical treatment is to amputate the penis.

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In the early stages under local anesthetic the physician will attempt to do manual reduction. The anesthesia is necessary to decrease the pain the procedure can cause. If manual manipulation is successful the foreskin can be retracted. During the procedure the physician will compress the penis and move the foreskin back to the normal position. This can be done by using cold compression and/or lubricant. If it is necessary to reduce the accumulation of fluids of the penile head before the manual reduction can be done then a surgical procedure will be necessary. This surgical procedure is done by circumcising the male or making a dorsal slit, which is an alternative method to circumcision. Another method to get rid of the accumulation of fluid is called the Dundee technique, which entails using a fine needle to put multiple punctures in the swollen foreskin and then using manual pressure to get rid of the extra fluid.

The only treatment that can make sure that paraphimosis does not happen again is that the man will need to be circumcised.

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