MEDICALLY REVIEWED

Understanding Paraphimosis: A Critical Urological Condition

paraphimosis

Paraphimosis is a less commonly discussed yet important urological condition that can have serious implications if not treated promptly. 

This condition primarily affects uncircumcised males and occurs when the foreskin, once retracted, cannot return to its original position over the glans penis. Immediate medical attention is crucial in such cases to prevent severe complications. We get further insights from Dr.Taufiq Rashid, physician at Pulse Clinic to share with us more about this condition.

What is Paraphimosis?

Dr Taufiq describes paraphimosis as a condition where ‘the foreskin is retracted behind the head of the penis and is unable to return to its original position’. It is recognisable by the inability to pull the foreskin forward over the glans penis after it has been retracted behind the coronal ridge. 

This condition is different from phimosis. In phimosis, the foreskin cannot be retracted over the glans at all. Paraphimosis generally occurs in uncircumcised or partially circumcised males and can happen at any age, although it is more common in older males and children.

Causes and Risk Factors

Several factors can lead to paraphimosis:

  • Medical procedures: Improper handling of the foreskin during medical exams or catheter placement can cause paraphimosis.
  • Poor hygiene: Inadequate cleaning can lead to infections, contributing to the foreskin’s inability to return to its normal position.
  • Vigorous sexual activity or masturbation: These activities can sometimes lead to paraphimosis if the foreskin is forcefully retracted.
  • Injury or infection: Swelling due to an injury or infection can prevent the foreskin from moving back to its natural position.

Dr Taufiq noted that it happens most often during sexual intercourse or masturbation. He added, ‘The foreskin is accidentally pulled back forcefully behind the head of the penis, but because the skin is too tight, it gets stuck and is unable to return to its original state. This leads to swelling and further worsening of the paraphimosis. Risk factors would include preexisting phimosis.’ 

Symptoms and Signs

The symptoms of paraphimosis are typically very apparent and can include:

  • Swelling of the glans penis
  • Pain in the penis
  • Redness or discoloration
  • Inability to move the foreskin forward over the glans

Why Is It a Medical Emergency?

Paraphimosis is considered a medical emergency due to the risk of cutting off blood flow to the tip of the penis. If left untreated, this can lead to severe swelling, pain, and even gangrene, which can be a life-threatening condition.

Diagnosis and Treatment

Diagnosis of paraphimosis typically involves a physical examination. Thereafter, the doctor will look at the symptoms and assess the condition of the penis.

You should seek treatment immediately, which typically involves manually reducing the swelling. This process might include:

  • Compression: Applying gentle pressure to the glans can reduce swelling, making it easier to move the foreskin back into place.
  • Hydration and lubrication: Applying ice and lubricants can assist in reducing swelling and facilitate the foreskin’s movement.
  • Surgical intervention: In severe cases where manual methods fail, a medical professional may make a small incision to relieve the pressure or in extreme cases, perform a circumcision under local anaesthesia, as Dr Taufiq explains.
  • If left untreated, it can cause further swelling and, worst case: strangulation of the penis, restricting blood supply and, eventually, cell death..

Prevention

Prevention of paraphimosis revolves around proper genital hygiene and care. This includes gently retracting and cleaning under the foreskin regularly. It also includes ensuring that the foreskin is returned to its normal position after retraction. Being cautious during medical examinations and procedures is also crucial.

There is a risk of recurrence. Dr Taufiq stated that ‘Sometimes paraphimosis recurs and the patient finds it difficult to reduce the phimosis despite stretching it. The doctor would then recommend circumcision. Circumcision involves the removal of the foreskin via surgical procedure. Typically, doctors perform the procedure under local anesthesia in the clinic..’

The Bottom Line

Paraphimosis is a serious condition that requires immediate medical attention. Therefore, awareness of its symptoms, causes, and treatment options is crucial for preventing severe complications. Regular self-examination and maintaining good hygiene practices can go a long way in preventing this condition. Finally, if you suspect paraphimosis, it is vital to seek immediate medical assistance for a positive outcome.

Dr Taufiq is the Medical Director at PULSE Clinic Singapore. Dr Taufiq has a special interest in Sexual Health, HIV prevention and Men’s health. He is of the view that everyone deserves to feel empowered by taking charge of their health. In his free time, he enjoys belting out the latest tunes, dancing behind closed doors, travelling to exotic locations and meeting new people over a cup of well-brewed coffee.

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