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What Is Paraphimosis?

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.

Paraphimosis most often occurs when a healthcare provider handles the foreskin improperly. They may not return the foreskin back to its normal position after a physical exam or medical procedure.

Paraphimosis shouldn’t be confused with phimosis. Phimosis is a condition in which the foreskin can no longer be pulled back from the tip of the penis. It typically occurs in younger children, and it usually isn’t a serious condition. Paraphimosis, however, is an emergency condition. Contact your doctor or go the hospital immediately if you’re experiencing symptoms of paraphimosis.

What Are the Symptoms of Paraphimosis?

The main symptom of paraphimosis is the inability to return the foreskin back to its normal position over the tip of the penis. The foreskin and the tip of the penis may be swollen and painful. The tip of the penis may also be dark red or blue due to a lack of blood flow.

Call your doctor right away if you discover any of these symptoms.

What Causes Paraphimosis?

Paraphimosis most commonly occurs when a healthcare professional forgets to pull the foreskin back to its normal position after a medical examination or procedure.

Other causes of paraphimosis include:

  • having an infection
  • experiencing physical trauma to the genital area
  • pulling the foreskin back too forcefully
  • having a foreskin that’s tighter than normal
  • having a foreskin that has been pulled back for an extended period

How Is Paraphimosis Diagnosed?

Your doctor can diagnose paraphimosis by simply performing a physical examination and inspecting the penis. They’ll also ask you about your symptoms and any other problems you may be experiencing with the penis or foreskin.

How Is Paraphimosis Treated?

Treatment will vary depending on your age and the severity of your condition. In general, the first step in treating paraphimosis is to reduce the swelling. Your doctor may do the following:

  • apply ice to the area
  • wrap a bandage tightly around the penis
  • use needles to drain pus or blood
  • inject hyaluronidase, which is an enzyme that helps reduce swelling

Your doctor may also make a small incision to relieve tension, but they’ll only do this in severe cases.

Once the swelling is reduced, your doctor will move the foreskin back into position. This can be very painful, so you’ll likely be given painkillers before the procedure starts. Painkillers might include an anesthetic, a nerve block, or an oral narcotic. During the procedure, your doctor will first lubricate the penis and foreskin. They’ll then gently squeeze the tip of the penis while also pulling down on the foreskin.

A complete circumcision, or removal of the foreskin, may be necessary in very severe cases of paraphimosis. This will also prevent the condition from happening again.

Make sure to follow your doctor’s instructions carefully after either procedure and to take any prescribed medications. Your doctor will teach you how to clean and care for the tip of the penis after treatment.

Call your doctor right away if you develop a high fever and if you’re still experiencing pain after treatment. These symptoms may indicate an infection, which must be treated with antibiotics.

What Are the Potential Complications of Paraphimosis?

Paraphimosis may lead to serious complications if it isn’t treated quickly. The condition can cause reduced blood flow in the penis, which deprives the tissues of oxygen. When this happens, paraphimosis can result in:

  • a severe infection
  • damage to the tip of the penis
  • gangrene, or tissue death, resulting in the loss of the tip of the penis

What Is the Outlook for People with Paraphimosis?

The chances of a full recovery are high when paraphimosis is treated right away. Once the swelling is reduced and the foreskin is returned to its normal position, most people recover without complications.

How Can Paraphimosis Be Prevented?

A complete circumcision can prevent paraphimosis. If you aren’t circumcised, paraphimosis can be prevented by:

  • practicing good hygiene and cleaning the tip of the penis regularly
  • always placing the foreskin back over the tip of the penis after it has been pulled back for cleaning, sexual intercourse, or urination
  • making sure that a healthcare provider has pulled the foreskin back to its normal position after an exam or procedure
  • never leaving the foreskin behind the tip of the penis for extended periods of time

Content licensed from:

Written by: Mary Ellen Ellis and Jacquelyn Cafasso
Medically reviewed on: Jan 11, 2016: George Krucik, MD MBA

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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