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Male reproductive anatomy
Male reproductive anatomy

Paraphimosis
Definition:
Paraphimosis is the inability of an uncircumcized male to pull the retracted foreskin over the head of the penis.

Causes, incidence, and risk factors:

Paraphimosis is caused by inflammation and narrowing of the foreskin. The inflammation may be caused by infection and is possibly associated with poor personal hygiene. Occasionally inflammation develops after direct trauma to the area, which results in swelling. Uncircumcised males and those who may not have been appropriately or completely circumcised are at risk.

The strictured foreskin is retracted behind the glans penis and left there for some period of time. Blood flow from penis is blocked, and the glans becomes swollen. The increased size of the glans then prevents the foreskin from being returned to its extended position. If paraphimosis is left untreated, the blood flow to the glans is impaired; lack of blood flow to the glans may result in loss of the penis tip.

Paraphimosis usually occurs most often in children and the elderly.
Symptoms:
  • an inability to pull the retracted foreskin over the head of the penis
  • a painful swelling at the end of the penis
  • penis pain
Signs and tests:

A physical examination confirms the diagnosis.
Treatment:

Compression of the head of the penis while applying forward traction on the foreskin may reduce the paraphimosis. If this fails, prompt surgical intervention (circumcision) will be necessary.
Expectations (prognosis):
The probable outcome is excellent if the condition is diagnosed and treated rapidly.
Complications:

If the condition is not relieved rapidly, gangrene or permanent damage to the penis may occur.
Calling your health care provider:
Go to your local emergency room if this occurs.
Prevention:

Circumcision, when performed properly, prevents the possibility of developing this condition.
Review Date: 5/25/2002
Reviewed By: Young Kang, M.D., Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.
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