Paraphimosis (patient information)

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Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

Overview
Paraphimosis occurs when the foreskin of an uncircumcised male cannot be pulled back over the head of the penis.

What are the symptoms of Paraphimosis?
The foreskin is pulled back (retracted) behind the rounded tip of the penis (glans) and stays there. The retracted foreskin and glans become swollen. This makes it difficult to return the foreskin to its extended position.

Symptoms include:
 * Inability to pull the retracted foreskin over the head of the penis
 * Painful swelling at the end of the penis
 * Pain in the penis

What causes Paraphimosis?
Causes of paraphimosis include:
 * Direct trauma to the area
 * Failure to return the foreskin to its normal location after urination or washing (most common in hospitals and nursing homes)
 * Infection, which may be due to poor personal hygiene
 * Uncircumcised males, and those who may not have been correctly or completely circumcised, are at risk.

Who is at highest risk?
Paraphimosis occurs most often in children and the elderly.

When to seek urgent medical care?
Go to your local emergency room if this occurs.

Diagnosis
A physical examination confirms the diagnosis. The health care provider will usually find a "doughnut" around the shaft near the head of the penis (glans).

Treatment options
Pressing on (compression of) the head of the penis while pushing the foreskin forward may reduce the swelling due to paraphimosis. If this fails, prompt surgical circumcision will be needed.

Where to find medical care for Paraphimosis?
Directions to Hospitals Treating Paraphimosis

What to expect (Outlook/Prognosis)?
The outcome is likely to be excellent if the condition is diagnosed and treated quickly.

Possible complications
If paraphimosis is left untreated, it can disrupt blood flow to the tip of the penis. In extreme (and rare) cases, this may lead to:
 * Damage to the penis tip
 * Gangrene
 * Loss of the penis tip

Prevention
Circumcision, when done correctly, prevents this condition.