Paraphimosis

 
Paraphimosis is a painful swelling of the retracted foreskin of the penis.

What is going on in the body?

When the foreskin is retracted it usually slips back over the glans, or head of the penis, if the penis is not erect. Sometimes the foreskin remains retracted, restricting the flow of blood out from the glans. This causes swelling, and the ring of tissue that keeps the foreskin from slipping back over the glans tightens even more. If the foreskin is left in a retracted position long enough, the painful swelling known as paraphimosis can result.

What are the signs and symptoms of the condition?

The glans penis is red and swollen, and surrounded at its base by a very swollen ring of tissue. The constricting band may not be visible if there is a lot of swelling around it.

What can be done to prevent the condition?

Good skin care of the uncircumcised penis will prevent paraphimosis. This means that after the foreskin has been retracted, it should be deliberately replaced over the glans penis.

How is the condition diagnosed?

Paraphimosis occurs only in males who are not circumcised. A physical exam can confirm the diagnosis.

What are the long-term effects of the condition?

If paraphimosis is not treated, the glans penis can be seriously damaged. Damage to the penis generally can be avoided if treatment is prompt.

What are the treatments for the condition?

Most cases can be treated with gentle but firm pressure to the glans penis to reduce the swelling. This allows the foreskin to be put back into its proper position. Sometimes local anesthesia is used to ease the discomfort of this procedure.

If the paraphimosis has been going on for a long time, this simple procedure may not be enough. In that case, minor surgery may be needed. An incision, or slit, is made through the constricting ring to release the constriction. This leaves the foreskin undamaged except for the dorsal, or back side, slit. A complete circumcision, or removal of the foreskin, can be done. But it is usually better not to do this when there is so much swelling.

What happens after treatment for the condition?

Recurrence of paraphimosis is fairly common. To prevent this, an elective circumcision is usually done once the acute swelling is gone. A dorsal slit or circumcision may have complications such as bleeding, skin infection, and damage to the skin of the penis.

How is the condition monitored?

Until a circumcision can be done, the male should check his penis often to be sure the foreskin is correctly replaced over the glans penis.

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