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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.<refname="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><refname="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><refname="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>[http://www.nocirc.org/publishname="NOCIRCpretract"/6pam.pdf ''Answers to Your Questions About Premature (Forcible) Retraction of Your Son's Foreskin'']. San Anselmo: NOCIRC, 2000.</ref>

== 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>Berk DA, Lee R. [http://www.aafp.org/afp/20040215/letters.html Paraphimosis in a middle-aged adult after intercourse]. ''Am Fam Physician'' 2004;69(4):807.</ref> The foreskin can then be brought forward to its normal position. Application additional methods of ice may also be helpful.<ref>[http://www.nocirc.org/publish/6pam.pdf ''Answers to Your Questions About Premature (Forcible) Retraction of Your Son's Foreskin'']. San Anselmo: NOCIRC, 2000reducing paraphimosis.</ref>

There is are a number of hospital treatment options available. Injection of hyaluronidase has been shown to be successful.<ref>name="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><refname="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 DA, Lee R. [http://www.aafp.org/afp/20040215/letters.html Paraphimosis in a middle-aged adult after intercourse]. ''Am Fam Physician'' 2004;69(4):807.<" /ref> 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.<refname="Berk" />  Reynard and Barua recommend the puncture technique.<ref name="Reynard">Berk DAReynard JM, Lee RBarua JM. [http://www.aafpcirp.org/afplibrary/20040215treatment/letters.html Paraphimosis in a middlephimosis/reynard1/ Reduction of paraphimosis the simple way -aged adult after intercoursethe Dundee technique]. ''Am Fam PhysicianBJU'' 2004Int 1999;6983(47):807859-860.</ref> Incisions are not necessary. Improved cosmetic outcome is claimed. Again no circumcision is necessary.<ref name="Berk"/>

Reynard and Barua Turner et al. recommend using Adson forceps to apply traction to return the puncture techniqueprepuce to its normal forward position.<refname="Turner">Reynard JMTurner CD, Barua JMKim HL, Cromie WJ. [http://www.cirp.org/library/treatment/phimosisparaphimosis/reynard1turner1/ Reduction Dorsal band traction for deduction of paraphimosis the simple way - the Dundee technique]. ''BJUUrology'' Int 1999;83(7)54:859917-860.</ref> Incisions are not necessary. Improved cosmetic outcome is claimed. Again no circumcision is necessary.<ref>Berk DA, Lee R. [http://www.aafp.org/afp/20040215/letters.html Paraphimosis in a middle-aged adult after intercourse]. ''Am Fam Physician'' 2004;69(4):8078.</ref>

Turner et al. Some doctors recommend using Adson forceps [[circumcision]] as treatment, but there is no evidence in the medical literature to apply traction to return support this recommendation. Additionally, this radical form of treatment sacrifices the [[prepuce ]], where patients may seek to preserve its normal forward position.<ref>Turner CD, Kim HLfunction and value, Cromie WJ. [http://www.cirp.org/library/treatment/paraphimosis/turner1/ Dorsal band traction for deduction and protection of paraphimosis]. ''Urology'the individual from unnecessarily radical surgery is always a doctor' 1999;54:917-8s prerogative.</ref>

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 JM, Barua JM. [http://www.cirp.org" /library/treatment/phimosis/reynard1/ Reduction of paraphimosis the simple way - the Dundee technique]. ''BJU'' Int 1999;83(7):859-860.</ref> The foreskin [[foresk should be returned to the forward position after cleaning or sexual intercourse.<refname="Choe">Choe JM. [http://www.aafp.org/afp/20001215/2623.html Paraphimosis: current treatment options]. ''Am Fam Physician'' 2000;62:2623-262828.</ref><refname="Berk"/>Berk DA Some doctors recommend [[Adolescent and adult circumcision| circumcision]] as prevention, Lee Rbut 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.aafpintactaus.org/afpinformation/20040215functionsoftheforeskin/lettersfunction] and value, and protection of the individual from unnecessarily radical surgery is always a doctor's prerogative.html Paraphimosis  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 middle-aged adult after intercoursestate of [[erection]]. ''Am Fam Physician'' 2004;69(4):807.</ref> {{SEEALSO}}* [[Foreskin]]* [[Gliding action]]* [[Penis]]* [[Phimosis]]* [[Reduction of paraphimosis]]* [[Stretching]]* [[Tissue expansion]]

Some doctors recommend circumcision as prevention, but there is {{LINKS}}* {{REFjournal |last=Choe |first=Jong M |init= |author-link= |etal=no evidence in the medical literature to support this recommendation |title=Paraphimosis: Current Treatment Options |trans-title= |language= |journal=Am Fam Physician. Furthermore |location= |date=2000-12-15 |season= |volume=62 |issue=12 |article= |page= |pages=2623-6, this 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 prerogative2628 |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}}

[[Category:Medical Conditionscondition]]