Paraphimosis

ExitCare ImageParaphimosis is a condition that involves the foreskin of the penis (the fold of skin that stretches over the tip of the penis). It can occur in boys or men who have not been circumcised (had the foreskin removed). Or, it can develop if the entire foreskin was not removed in circumcision. It also can occur if the procedure was done incorrectly.

Paraphimosis can develop if the foreskin is very tight. It can become stuck when it is pulled back. It cannot be returned to its normal position. This can keep blood from flowing to the tip of the penis. It can cause swelling and pain. Infection can result.

This is a serious condition. It can be an emergency. Do not delay in getting treatment.

CAUSES

Causes of paraphimosis include:

  • A foreskin that is tighter than normal.

  • Infection under the foreskin. This could be caused by:

  • Not cleaning the tip of the penis well.

  • Genital piercing.

  • Another medical condition, such as diabetes.

  • Trauma to the area. For example, the tip of the penis might have been hit hard.

  • A foreskin that has been pulled back for too long.

  • A forceful retraction of the foreskin in attempting to clean the penis. This can cause the head of the penis to swell. Then, the foreskin cannot return to its natural position.

SYMPTOMS

  • When the foreskin is retracted (pulled back), it stays in that position.

  • Painoften at the tip of the penis.

  • Swelling of the penis.

DIAGNOSIS

To decide if you have paraphimosis, a healthcare provider will probably:

  • Ask about symptoms you have noticed.

  • Ask about your health overall.

  • Ask about any problems you have had with the penis or foreskin.

  • Examine the penis.

TREATMENT

Paraphimosis can be treated several ways. Most of the time, treatment can be done in a clinic or a healthcare provider's office. Be sure to discuss the different options with your caregiver. They include:

  • Forcing the foreskin back over the tip of the penis. You may be given painkillers for this procedure. Also, any swelling must be reduced first. To do this:

  • Ice may be used.

  • A bandage may be wrapped tightly around the penis.

  • Needles may be used to drain any pus or blood that is causing the swelling.

  • Dorsal slit procedure. A small cut is made in the tightened foreskin. This frees it. Then, it can be pulled back into place.

  • Circumcision. This is surgery to remove the foreskin. It may be needed if the foreskin cannot be moved back into place. This also would prevent paraphimosis from developing again.

HOME CARE INSTRUCTIONS

  • The treated area may be covered with gauze or a bandage. What you will need to do will depend on the treatment you had. Ask:

  • How often the bandage should be changed?

  • If the area can get wet?

  • When you can leave the skin uncovered?

  • Apply any creams that your healthcare provider prescribed. Follow the directions carefully.

  • Take any medications prescribed by your healthcare provided. Follow the directions carefully.

  • Learn how to clean and care for the tip of the penis after treatment. After the swelling has subsided, talk to your caregiver about the proper way to care for the hygiene of the penis.

SEEK MEDICAL CARE IF:

  • The treated area of skin does not heal. It can become more irritated and red or bloody.

  • Urination is difficult or painful.

  • Pain in the penis continues, even after taking pain medication.

  • You have any questions about how to use creams or medications that were prescribed.

  • You develop a fever of more than 101° F (38.3° C).

SEEK IMMEDIATE MEDICAL CARE IF:

You develop a fever of more than 102.0° F (38.9° C)