What is Paraphimosis?

Paraphimosis is a condition wherein the foreskin of the penis cannot be returned to its original position. The foreskin usually gets stuck behind the head of the penis in such cases. This condition can only happen in males who are not circumsized. In newborn males, physiologic paraphimosis can occur naturally but will eventually resolve as the boy ages. When it happens after the foreskin has been retractable or after puberty, paraphimosis then becomes an emergency medical condition.

In uncircumsized men, paraphimosis may be caused by the failure to pull the foreskin back after cleaning or after sexual intercourse, thus leaving the foreskin behind the head of the penis. Catheter insertion and thorough medical examinations of the penis can also lead to paraphimosis if the foreskin is not returned to its normal position after the exam. On rare occasions, ring piercings in the head of the penis can also lead to the condition.

Leaving the foreskin behind the penis for a longer period than necessary can lead to the swelling of the penis head, which may trap the foreskin behind it. When the foreskin gets trapped behind the head of the penis, it forms a constricting ring. This can cause edema, or accumulation of fluid, in the penile head. The head area of the penis can then look very red and swollen, aside from being soft and painful.

As the edema continues to worsen, blood flow to the area is affected, which can lead to severe pain and sometimes result in gangrene if not corrected. Gangrene is death of cells caused by loss of blood supply to the area, in this case the head of the penis, making it appear black or blue and firmer when touched. This process is irreversible, and can result to amputation of the affected part. As soon as paraphimosis is suspected, men should seek immediate medical treatment to prevent this from happening.

Treatment of paraphimosis often depends on the severity of the condition. Manual reduction is generally done by physicians, wherein a local anesthetic is used to lessen the pain from the procedure, and then the foreskin is retracted through manual manipulation. Surgical procedures may also be performed to reduce the edema of the penile head before performing the manual reduction. Circumcision, however, is the only treatment that can ensure that paraphimosis will not happen again.