Paraphimosis: Causes, Symptoms, Diagnosis & Treatment

Overview

What is paraphimosis?

Paraphimosis is a medical emergency. It happens to people who have partially circumcised or completely uncircumcised penises. The foreskin becomes trapped behind the head of the penis and can’t be pulled down to cover the end of the penis. This painful condition is serious and can cut off circulation to the tip of your penis.

How common is this condition?

Studies indicate that 0.2% of uncircumcised children aged 4 months to 12 years old will have paraphimosis. For uncircumcised people age 16 years and older, the rate rises to 1%. This is less common than other foreskin problems in both categories.

Symptoms and Causes

What are the symptoms of paraphimosis?

Symptoms of paraphimosis include:

  • Inability to pull the foreskin forward over the head of the penis to the tip. (Putting the foreskin back into its proper place is called foreskin reduction.)
  • Pain.
  • Swelling and discoloration (blue or purple coloring).

What causes paraphimosis?

Paraphimosis often happens when you pull back the foreskin to clean under it or if you’re trying to stretch the foreskin due to the foreskin being too tight. It can also happen if the foreskin is moved for something like a catheterization to drain urine or another type of medical procedure on the penis.

Diagnosis and Tests

How is paraphimosis diagnosed?

You will probably notice that your penis, or your child’s penis, has some swelling or discomfort. When you contact your healthcare provider, it’s likely that they will recommend you are seen in the emergency department for an exam and a foreskin reduction.

Management and Treatment

How is paraphimosis treated?

To treat paraphimosis, your healthcare provider may suggest:

  • Squeezing the tip of your penis to help the foreskin move back over the glans. Your provider might use solutions to lessen the swelling.
  • Making a slit in the foreskin (dorsal slit) to allow it to move back over the glans.
  • Circumcision surgery to remove some or all of the foreskin.

Paraphimosis is likely to recur. Due to this, your provider may suggest circumcision. If you aren’t a good candidate for circumcision, the dorsal slit procedure will help prevent a recurrence.

Your healthcare provider may also prescribe antibiotics to treat infection if necessary.

Although ice is said to reduce swelling, it’s not the best solution because ice could make your blood flow worse.

Surgical treatments have the following risks:

  • Bleeding.
  • Infection.

What are the complications of paraphimosis?

Untreated paraphimosis is dangerous. If the foreskin isn’t moved, the lack of blood flow to the penis could cause tissue damage (ischemia) or tissue death (necrosis).

Prevention

How can I prevent paraphimosis?

The only way to fully prevent paraphimosis is to be completely circumcised. Other ways that may help prevent this condition include:

  • Making sure that the foreskin is pulled down if you’ve been catheterized or had some other type of procedure on your penis.
  • Making sure that the foreskin is pulled back down if you’ve been cleaning yourself, if you’ve been doing foreskin stretching exercises, if you’ve just had sex or if you’ve used the toilet.
  • Not leaving the foreskin in a retracted position any longer than you need to for cleaning or other reasons.

Outlook / Prognosis

What is the outlook if I have paraphimosis?

Paraphimosis can be treated. With treatment, the outlook is excellent. If you’re not able to put your foreskin back into position manually, you run the risk of having it happen again. That’s why your provider is likely to suggest circumcision.

Living With

When should I see my healthcare provider?

You should contact your healthcare provider if you can’t move your foreskin back into place. You will probably have to be seen by your provider or in the emergency room.

Frequently Asked Questions

Is paraphimosis an emergency?

Yes. It’s important for you to get medical help as quickly as possible. Untreated, paraphimosis can cut off blood flow to your penis and cause permanent damage.

How do you manually reduce paraphimosis?

Really, you shouldn’t try to force your foreskin down over the tip of the penis. If you aren’t able to pull the foreskin down easily by perhaps squeezing to reduce swelling, contact your healthcare provider as quickly as you can.

Does paraphimosis go away on its own?

No. Paraphimosis won’t go away on its own.

What is the difference between paraphimosis and phimosis?

Phimosis and paraphimosis are both conditions that affect the foreskin. However, paraphimosis is always an emergency, while phimosis is not.

Paraphimosis happens to people with penises that are partially or completely uncircumcised. The foreskin becomes stuck behind the head of the penis and can’t be moved back toward the tip. Phimosis happens to people with uncircumcised or partially circumcised penises, the skin is unable to be pulled back to reveal the head of the penis. It could happen if you’re trying to do phimosis stretching exercises and you pull the foreskin back but can’t put it back in place. Treatment is required so that the tip of the penis isn’t damaged to the point of developing gangrene.

A note from Cleveland Clinic

Paraphimosis happens when a person with an uncircumcised or partially circumcised penis has a retracted foreskin that can’t be moved back into place over the head of the penis. It’s a medical emergency because the tightness can restrict blood flow to the penis and cause tissue damage or destruction. You need to contact your medical provider or go to the emergency room. This condition can be treated successfully.

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