What is Paraphimosis

Paraphimosis is a serious condition in which the fold of skin that stretches over the tip of the penis (foreskin) becomes stuck when it is pulled back.

This condition blocks blood from flowing away from the penis tip, and that causes swelling that gets worse and worse. Paraphimosis needs to be treated right away.

What are the causes?

This condition may be caused by:

• A foreskin that is tighter than normal.
• Leaving the foreskin pulled back after a procedure, such as after the placement of a catheter.
• A foreskin that has been pulled back for too long.
• A forceful pulling back of the foreskin.
• Infection under the foreskin.
• Trauma to the area, such as a hard hit to the the tip of the penis.
• Having sex or masturbating.
• Hair or clothing that gets wrapped around the penis.

What increases the risk?

This condition is more likely to develop in:

• Males who have not had their foreskin removed.
• Males who have frequent urological procedures.
• Males who have poor hygiene.
• Males who need help with daily hygiene from a caregiver.

What are the signs or symptoms?

Symptoms of this condition include:

• A foreskin that cannot be returned to its normal position.
• Pain, often at the tip of the penis.
• Swelling of the penis.
• Anxiety.
• Trouble urinating.
• Skin that is red or bluish at the tip of the penis.

How is this diagnosed?

This condition may be diagnosed with a physical exam. You may also have X-rays.

How is this treated?

This condition may be treated with:

• A procedure to force the foreskin back over the tip of the penis. Swelling may first be reduced with:
  • Ice.
  • A bandage wrapped tightly around the penis.
  • Needles to drain any pus or blood that is causing the swelling.
• Medicine to relieve pain. Medicine may be given by mouth, through an IV tube, or by an injection to the base of the penis (nerve block).
• A procedure in which a small cut (incision) is made in the tightened foreskin to free it and allow it to be pulled back into place (dorsal slit procedure).
• Surgery to remove the foreskin (circumcision). This may be done if the foreskin cannot be moved back into place.

Most of the time, treatment can be done in a clinic or a health care provider’s office.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Apply any creams to the affected area only as told by your health care provider.
• If the treated area is covered with gauze or a bandage (dressing), follow instructions from your health care provider about:
  • When and how you should change your bandage (dressing).
  • When you should remove your dressing.
  • Whether the area can get wet.
• Wear loose undergarments to avoid applying pressure to the area.
• Follow instructions from your health care provider about avoiding sexual activity.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• The treated area of skin does not heal, or it becomes more irritated, red, or bloody.
• Urination is difficult or painful.
• Pain in the penis continues, even after you take medicine for pain.

Get help right away if:

• You develop a fever.