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PARAPHIMOSIS

Paraphimosis is a condition that affects uncircumcised males where the foreskin becomes stuck behind the head of the penis and cannot be pulled forward. This can restrict blood flow to the tip of the penis and cause complications. It typically occurs when the foreskin is left retracted for too long after activities like sex, urination, or medical procedures. Treatment involves using pressure or puncturing the foreskin to release swelling so it can be pulled back into the proper position to allow blood flow to resume. Left untreated, paraphimosis risks damage to the penis tip including potential gangrene or loss of the tip.

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Emmeline Dycangchon-Garma
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118 views

PARAPHIMOSIS

Paraphimosis is a condition that affects uncircumcised males where the foreskin becomes stuck behind the head of the penis and cannot be pulled forward. This can restrict blood flow to the tip of the penis and cause complications. It typically occurs when the foreskin is left retracted for too long after activities like sex, urination, or medical procedures. Treatment involves using pressure or puncturing the foreskin to release swelling so it can be pulled back into the proper position to allow blood flow to resume. Left untreated, paraphimosis risks damage to the penis tip including potential gangrene or loss of the tip.

Uploaded by

Emmeline Dycangchon-Garma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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PARAPHIMOSIS

WHAT IS IT?
Paraphimosis is a condition that only affects uncircumcised males. It develops when the
foreskin can no longer be pulled forward over the tip of the penis. This causes the foreskin to
become swollen and stuck, which may slow or stop the flow of blood to the tip of the penis.
The condition can lead to serious complications if it isn’t treated.

WHAT ARE THE CAUSES?


Uncircumcised people sometimes pull the foreskin back during sex, when they go to the
bathroom, or when they clean their penises. Doctors and nurses might pull the foreskin back
when they examine the penis or put in a catheter.
Sometimes you, a doctor, or a nurse might forget to pull the foreskin back down. If the
foreskin is left behind the head of the penis too long, your penis might swell so much that the
foreskin is trapped behind it.
Other causes of paraphimosis:
 An infection. This can happen when the area is not washed well.
 An injury to the area. Injury can happen from vigorous sex, a piercing, scarring
from repeated infection, or an insect or spider bite.
 A circumcision that wasn’t done correctly.
 Diabetes, which can cause chronic inflammation of the penis and foreskin.

SIGNS AND SYMPTOMS

Symptoms of paraphimosis include:


 Inability to pull the foreskin forward over the head of the penis to the tip. (Putting the
foreskin back into its proper place is called foreskin reduction.)
 Pain.
 Swelling and discoloration (blue or purple coloring).

DIAGNOSTICS AND PROCEDURES

When evaluating a patient with suspected paraphimosis, a detailed history must be obtained
regarding penile manipulation, instrumentation, or endoscopic surgery of the bladder or
urethra. Any history of self-retraction should also be elicited. The patient must be asked
whether he has been circumcised or partially circumcised. Changes in skin texture and color
can make this determination difficult based on visual inspection alone.
The physical examination should focus on the penis, a urethral catheter (if present), and
scrotum. The penis should be inspected for the presence of foreskin, the color of the glans,
the degree of constriction around the penile corona, and the turgor of the prepuce. The
absence of foreskin excludes the diagnosis of paraphimosis. A pink or salmon hue to the
glans indicates a good blood supply. If the glans or prepuce appears to be black, auto necrosis
has begun. Palpation of the glans can provide additional information on the viability of the
glans. A normal glans is soft and pliant. If the glans feel firm and inelastic, with black areas
present, penile necrosis should be suspected.
Patients with paraphimosis often have an indwelling urethral catheter. Removal of the
catheter before manipulating the penis will aid in the successful reduction of paraphimosis.
However, the reason for the initial placement of the catheter should be obtained first so that,
if necessary, it can be replaced following the reduction of the paraphimosis.
Scrotal skin should be inspected for color, texture, and turgor. Scrotal contents should be
palpated for tenderness, hydrocele, or tumor.

MANAGEMENT AND TREATMENT

Pressure is applied to the swollen penis for 5-30 minutes, usually with a saline swab. Ice can
also be used. These treatments can compress the swelling, so pushing the penis while pulling
the foreskin back into place is easier.
If manual manipulation is unsuccessful, then a puncture technique may be required. This
treatment usually needs some form of local anesthesia or sedation. A needle is used to
puncture the foreskin in different places. This allows built-up fluid to be released and for the
manual manipulation of the foreskin over the penis to become easier.
More severe cases might require a small incision or slit in the foreskin to relieve restriction
and to allow the swelling to subside. This procedure requires local anesthesia. In some cases,
circumcision may eventually be required.

COMPLICATIONS
If paraphimosis is left untreated, it can disrupt blood flow to the tip of the penis. In extreme
(and rare) cases, this may lead to:
 Damage to the penis tip
 Gangrene
 Loss of the penis tip

PREVENTION

The only way to fully prevent paraphimosis is to be completely circumcised. Other ways that
may help prevent this condition include:

 Making sure that the foreskin is pulled down if you’ve been catheterized or had some
other type of procedure on your penis.
 Making sure that the foreskin is pulled back down if you’ve been cleaning yourself if
you’ve been doing foreskin stretching exercises, if you’ve just had sex or if you’ve
used the toilet.
 Not leaving the foreskin in a retracted position any longer than you need to for
cleaning or other reasons.

IS PARAPHIMOSIS AN EMERGENCY?

 It’s a medical emergency because the tightness can restrict blood flow to the penis and cause
tissue damage or destruction.

WHAT IS THE DIFFERENCE BETWEEN PARAPHIMOSIS AND PHIMOSIS?


Phimosis and paraphimosis are problems with the foreskin of the penis. Phimosis is when a
foreskin can’t be pulled down (retracted) from the tip of the penis. This is a common problem
in young boys. Paraphimosis is when the foreskin is retracted but can’t move back up. This
can prevent normal blood flow in the penis and may cause serious problems.
REFERENCES:

https://my.clevelandclinic.org/health/diseases/22244-
paraphimosis#:~:text=Paraphimosis%20happens%20when%20a%20person,cause
%20tissue%20damage%20or%20destruction.

https://www.medicalnewstoday.com/articles/318833#how-is-paraphimosis-treated

https://familydoctor.org/condition/paraphimosis/

https://medlineplus.gov/ency/article/001281.htm

https://www.aafp.org/pubs/afp/issues/2000/1215/p2623.html

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