Paraphimosis: Difference between revisions

Paraphimosis is a condition where a [[retraction of the foreskin|retracted]] [[foreskin]] becomes trapped behind the head of the penis, and thus unable to return to its forward position covering the glans. If the condition is prolonged, paraphimosis can become an emergency.<ref name="DeVries">DeVries CR, Miller AK, Packer MG. [http://www.cirp.org/library/treatment/phimosis/devries/ Reduction of paraphimosis with hyaluronidase]. ''Urology'' 1996 48(3):464-465</ref> <ref name="NOCIRCpretract">[http://www.nocirc.org/publish/6pam.pdf ''Answers to Your Questions About Premature (Forcible) Retraction of Your Son's Foreskin'']. San Anselmo: NOCIRC, 2000.</ref> <ref name="Berk">Berk DA, Lee R. [https://www.aafp.org/afp/2004/0215/p807.html Paraphimosis in a middle-aged adult after intercourse]. ''Am Fam Physician'' 2004;69(4):807.</ref> The tissue may become oedematous and swell thus further aggravating the problem.<ref name="NOCIRCpretract"/>

First aid for this condition is simple. The head of the penis must be squeezed very tightly between thumb and forefinger. This forces blood out of the head and reduces the size.<ref name="Berk"/> The [[foreskin]] can then be brought forward to its normal position. Application of ice may also be helpful.<ref name="NOCIRCpretract"/>

Some doctors recommend circumcision as treatment, but there is no evidence in the medical literature to support this recommendation. Additionally, this radical form of treatment sacrifices the prepuce, where patients may seek to preserve its function and value, and protection of the individual from unnecessarily radical surgery is always a doctor's prerogative.

Paraphimosis reduction without surgery.

Education concerning proper care and development of the prepuce is the most effective way of preventing paraphimosis from occurring. Parents, doctors, and other caretakers should be instructed to never [[forced retraction|forcibly retract]] a boy's foreskin. In older males, the forcible retraction of a narrow foreskin should be avoided.<ref name="Reynard" /> The foreskin should be returned to the forward position after cleaning or sexual intercourse.<ref name="Choe">Choe JM. [http://www.aafp.org/afp/20001215/2623.html Paraphimosis: current treatment options]. ''Am Fam Physician'' 2000;62:2623-28.</ref> <ref name="Berk"/>

Manual [[stretching]] of the tight tip of the [[foreskin]] to widen the narrow part will prevent recurrence of paraphimosis. Stretching is not complete until the foreskin will [[Gliding action| glide smoothly back and forth]] while the penis is in a state of [[erection]].