Paraphimosis is a medical condition where the foreskin, once retracted behind the head of the penis (glans), becomes trapped and cannot be returned to its normal position. This condition affects uncircumcised males. It is distinct from phimosis, a condition where the foreskin cannot be retracted at all. Prompt medical attention is necessary to prevent complications.
Understanding Paraphimosis
In uncircumcised individuals, the foreskin covers the glans (head of the penis). In paraphimosis, the foreskin is pulled back, often during cleaning, urination, or medical procedures, but then gets stuck behind the corona, the rounded border at the base of the glans. This retraction forms a tight band around the penis, leading to a constricted ring of tissue.
This constriction impedes the flow of venous blood and lymphatic fluid from the glans and foreskin, resulting in swelling, known as edema. As the swelling progresses, the tight band can further compromise arterial blood flow to the glans. This reduced circulation leads to pain and increased swelling, making the foreskin even more difficult to return to its original position.
Recognizing and Addressing Paraphimosis
Recognizing paraphimosis involves observing several key signs. The most apparent symptom is the inability to pull the retracted foreskin back over the glans. This is often accompanied by significant pain and swelling of the glans and foreskin. The glans may also appear discolored, ranging from dark red to bluish, due to restricted blood flow. Some individuals might also experience difficulty or pain during urination.
Paraphimosis is a medical emergency requiring immediate attention. Delayed treatment can lead to severe complications, including tissue damage, infection, or gangrene. If any symptoms are present, seeking emergency medical care is necessary.
Manual reduction is often the first approach to resolve paraphimosis. This involves gentle compression of the glans and swollen foreskin to reduce edema, followed by carefully guiding the foreskin back into place. This process may involve lubricants, cold compression, or osmotic agents like granulated sugar to help reduce swelling. If manual reduction is unsuccessful, a healthcare provider might perform a small incision in the constricting band of the foreskin, known as a dorsal slit, or, in severe or recurrent cases, a circumcision.
Causes and Prevention
Paraphimosis commonly occurs when the foreskin is retracted for hygiene, examination, or medical procedures (such as catheterization) and is then inadvertently left in the retracted position. Forcing a tight foreskin back, particularly in individuals with underlying phimosis (a condition where the foreskin cannot be easily retracted), can also lead to paraphimosis. Other factors include infections, physical trauma to the penis, or penile piercings.
Preventing paraphimosis involves proper foreskin care. After retracting the foreskin for cleaning or during medical procedures, it is important to return it to its normal, unretracted position promptly. Daily gentle cleaning of the penis includes retracting the foreskin, washing the area with warm water, and then returning the foreskin. Avoiding forceful retraction of a tight foreskin is also important. For individuals prone to paraphimosis or with a history of the condition, a healthcare provider may discuss options such as circumcision to prevent recurrence.