Paraphimosis is a serious condition that manifests only in uncircumcised males, where the retracted foreskin cannot be pulled back to its normal position over the glans penis. The foreskin becomes trapped beneath the head of penis and acts as a tourniquet to compromise blood supply to penis.
SYMPTOMS

• Inability to pull the foreskin back to its normal position over glans
• Pain
• Discomfort
• swelling of glans
• in severe cases after prolonged retraction , it can lead to discoloration and gangrene of glans penis

DIAGNOSIS
It can be diagnosed with history and physical examination
TREATMENT
Paraphimosis is an emergency and needs intervention urgently. Prolonged cases may result in loss of penis.

• Application of local anesthetic agent over the penis and then gently compression over it while pulling the foreskin back towards the tip is the first line of management.
• If this does not help , then a small incision in the foreskin to relieve the pressure can be performed.
• In severe cases, circumcision(removal of foreskin) is performed.

FAQs
1. What are the causes?
Mishandling of foreskin( not returning it back after retracting for cleaning, urination, intercourse, catheterization, cystoscopy or penile examination)
Phimosis (tight foreskin)
Infection
Penile piercing or trauma to penis
2. What are the complications?
Severe infection
Loss of penis due to gangrene(loss of blood supply)
3. What is the long-term outlook of this condition?
If the condition is diagnosed and treated well in time, then there are good chances of recovery. In that case, recovery is complete and without complication
4. How can this condition be prevented?
Circumcision is the best preventive method. In uncircumcised males, maintaining good hygiene of penis and foreskin and careful handling of foreskin(always make sure to pull the foreskin back over the glans after retraction for cleaning, urination, intercourse, examination etc.)
5. How long does the procedure take? Does it need hospital admission?
Non-surgical intervention is usually performed in the emergency room, and once the foreskin is back in place and there is symptom relief , the patient can go home.
Surgical intervention can be done as a day case emergency procedure under local anaesthesia or intravenous sedation. Once the patient is comfortable and there are signs of improvement, the patient is discharged.

 

Written by : Dr. Sobia Yasmeen
Copyrights: Pakistan association of Plastic Surgeons