Paraphimosis is a urological condition that occurs when an uncircumcised male’s foreskin retracts and cannot be pulled back over the head of the penis. If the foreskin remains behind the head of the penis for too long, swelling and reduced blood flow may occur, which can be serious. Medical attention should be sought immediately when an individual develops paraphimosis.
Causes
Many situations can contribute to paraphimosis, including improper circumcision, injury to the genital area, infection, and failure to pull the foreskin over the tip of the penis after washing or urinating. Also, poor hygiene, repeated infections of the foreskin, and swelling as a result of an insect bite can lead to the condition. Less commonly, paraphimosis can develop as a result of vigorous sexual activity, penile piercing, or an overly constricting penile ring.
Symptoms
Paraphimosis can many it difficult or impossible to urinate. It can also affect the flow of blood to the tip of the penis, causing harm or even loss. The first obvious symptom of paraphimosis is the inability to pull the foreskin of the penis over the head. This distinct sign may be accompanied by pain, swelling, difficulty urinating, or darkened tissue at the tip of the penis. However, not all individuals with paraphimosis experience pain.
Risk Factors
Uncircumcised young boys and elderly men develop this disorder most often, the latter primarily because poorly managed diabetes can cause inflammation in the foreskin, making it hard to pull over the head. Having a catheter inserted without the foreskin being pulled over the head of the penis may also cause paraphimosis.
Diagnosis
A physician may diagnose paraphimosis through visual or physical examination of the genital area. Typically, a thick, tight band of foreskin is trapped behind the head of the penis. In some cases, however, swelling can mask the condition. Background information and additional tests can help the doctor identify the cause of the condition and recommend treatment for any infections.
Treatment Options
A saline swab applied with pressure to the tip of the penis or an application of ice can reduce swelling caused by paraphimosis, making it easier to pull the foreskin over the tip of the penis. However, if these measures don’t work, the doctor may turn to a puncture technique using local anesthesia or sedation. A needle punctures different areas of the foreskin to reduce the swelling and release built-up fluid, allowing the foreskin to return to its normal position. In some cases, a doctor may inject an enzyme called hyaluronidase into the foreskin to reduce the swelling. In worst-case scenarios, a small slit or incision can reduce the swelling further. If other measures fail or if the condition recurs, the doctor may recommend circumcision.
Preventative Measures
Good hygiene helps boys and men avoid infections that can lead to swelling. Of course, circumcision is a good way to completely prevent paraphimosis, though a poorly performed operation can lead to the condition.
Secondary Conditions
In some situations, paraphimosis may cause other problems that increase the severity of the condition. For example, it is possible to develop gangrene as a result of paraphimosis. The very young and those of advanced age are most commonly affected by complications.
Outlook
Although paraphimosis can become serious if left untreated, early diagnosis and treatment usually lead to good results, and long-term complications are rare. The key to successfully managing paraphimosis lies in treating it as quickly as possible, thereby reducing the risk of loss of blood flow.
Additional Preventative Behaviors
Regular cleanliness is the best way to prevent paraphimosis. For men who are prone to the condition, cleaning the genital area after sexual contact and taking great care when receiving and cleaning genital piercings and other sexual enhancement modifications may further prevent problems.
Final Treatment Options
If treatment for paraphimosis is unsuccessful, circumcision is usually the ultimate solution. Eliminating the foreskin effectively eliminates the possibility of this covering swelling or becoming infected.