Paraphimosis

Written by Mary Ellen Ellis | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

Paraphimosis is a condition that affects uncircumcised males and occurs when the foreskin can no longer be pulled forward over the tip of the penis. The foreskin can then become swollen and stuck, which may slow or stop the flow of blood, and can be very serious if not treated. Paraphimosis most often occurs as the result of physical trauma to the groin area, infection, or failure to return foreskin to its unretracted position after urination or washing.

Paraphimosis should not be confused with phimosis, a condition where the foreskin cannot be pulled back from the tip of the penis. Phimosis typically occurs in younger children, and is not usually an emergency situation. Paraphimosis, on the other hand, is an emergency condition—if you are experiencing symptoms of this problem, contact your doctor or other health care professional immediately.

Causes of Paraphimosis

Paraphimosis occurs only in uncircumcised males and commonly affects children and the elderly.

Paraphimosis typically occurs in hospitals and nursing homes, and is usually caused by a medical professional failing to return the foreskin to its unretracted position after an exam or a procedure. In rare cases, paraphimosis can be caused by an infection or genital piercings.

Recognizing the Symptoms of Paraphimosis

The main symptom of paraphimosis is the inability to return the foreskin to its unretracted position over the tip of the penis. The foreskin may look swollen and physically pulling on it will not cause it to move back into its unretracted position. Other symptoms include:

  • swelling in the foreskin and tip of the penis
  • pain in the penis
  • dark red or blue coloring on the tip of the penis

If you discover any of these symptoms, seek medical attention immediately.

Diagnosis and Treatment of Paraphimosis

A doctor can diagnose paraphimosis with a physical examination. Treatment will vary depending on age as well as the type and extent of the condition.

In most cases, a doctor will physically move the foreskin back into position by lubricating the penis and foreskin, and then gently squeezing the tip of the penis while also pulling down on the foreskin. Because this can be very painful, the patient will usually get an anesthetic, nerve block, or oral narcotic before the procedure is done. The doctor will attempt to reduce swelling with ice; however more severe swelling may require an injection of hyaluronidase (an enzyme that helps reduce swelling), or a small incision to relieve tension.

In very severe cases, a complete circumcision (removal of the foreskin) may be necessary.

If treated at the first sign of a problem, the chances of a full recovery from paraphimosis are very good. As long as the swelling is reduced and the foreskin is brought back over the head of the penis, a full recovery can be expected.

If left untreated, the consequences can be severe. Because paraphimosis causes a restriction of blood flow in the penis, it can result in damage to the tip of the penis, serious infection, or the loss of the tip of the penis.

How Can Paraphimosis Be Prevented?

A complete circumcision can prevent paraphimosis. In males who are not circumcised, paraphimosis can be prevented by practicing good hygiene and by always placing the foreskin back over the tip of the penis after it has been pulled back for cleaning, examination, or a medical procedure.

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