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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. [httphttps://www.aafp.org/afp/200402152004/0215/lettersp807.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"/>

First aid See the Video section 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 additional methods of ice may also be helpfulreducing paraphimosis.<ref name="NOCIRCpretract"/>

There is are a number of hospital treatment options available. Injection of hyaluronidase has been shown to be successful.<ref name="DeVries"/><ref name="NOCIRCpretract"/>[<ref name="Berk" /> Hyaluronidase works by reducing the oedema, after which the foreskin may be returned to its normal position. When the foreskin has been returned to its normal position, no further treatment is necessary.<ref name="Berk" />

Turner ''et al''. recommend using Adson forceps to apply traction to return the prepuce to its normal forward position.<ref name="Turner">Turner CD, Kim HL, Cromie WJ. [http://www.cirp.org/library/treatment/paraphimosis/turner1/ Dorsal band traction for deduction of paraphimosis]. ''Urology'' 1999;54:917-8.</ref> 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.

Some doctors recommend circumcision as treatment, but there is no evidence in the medical literature to support this recommendation==Video==Dr. 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 Pravin H. Shinde demostrates paraphimosis reduction without surgery.<br><br><youtube>A21gDqW5e4E</youtube> Paraphimosis reduction without surgery is always a doctor's prerogative.<youtube>v=xBE8UmREne0</youtube>

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 [[foresk 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;62:2623-262828.</ref> <ref name="Berk"/>

Some doctors recommend [[Adolescent and adult circumcision | circumcision]] as prevention, but there is no evidence in the medical literature to support this recommendation. Furthermore, this sacrifices the prepuce, where patients may seek to preserve its [http://www.intactaus.org/information/functionsoftheforeskin/ function ] and value, and protection of the individual from unnecessarily radical surgery is always a doctor's prerogative.

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]]. {{SEEALSO}}* [[Foreskin]]* [[Gliding action]]* [[Penis]]* [[Phimosis]]* [[Reduction of paraphimosis]]* [[Stretching]]* [[Tissue expansion]] {{LINKS}}* {{REFjournal |last=Choe |first=Jong M |init= |author-link= |etal=no |title=Paraphimosis: Current Treatment Options |trans-title= |language= |journal=Am Fam Physician. |location= |date=2000-12-15 |season= |volume=62 |issue=12 |article= |page= |pages=2623-6, 2628 |url=https://www.aafp.org/pubs/afp/issues/2000/1215/p2623.html |archived= |quote= |pubmedID=11142469 |pubmedCID= |DOI= |accessdate=2022-06-08}}* {{REFweb |url=https://www.cirp.org/library/treatment/paraphimosis/ |title=Paraphimosis: Conservative Treatment |last=Anonymous |first= |init= |publisher=Circumcision Reference Library |date=2004-04-17 |accessdate=2023-04-20}}