Paraphimosis is a problem that can happen in an uncircumcised or partly circumcised child or adult. Circumcision is when the foreskin of the penis is removed. It's usually done in the first few days after birth. The foreskin is the thin layer of skin that covers the end of the penis. Paraphimosis happens when the foreskin of the penis is pulled back, gets stuck behind the head of the penis, and won’t go back to the forward position. This causes the tissues to swell. It can become bad enough to stop blood flow to the head of the penis.
What causes paraphimosis?
Paraphimosis can occur when you or a caregiver pull back the foreskin. This can be for cleaning, placing a urinary catheter, or other procedures or exams. If the foreskin isn't put back over the head of the penis promptly, it can lead to paraphimosis.
Other causes include:
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Injury to the penis.
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Infection.
What are the symptoms of paraphimosis?
Symptoms of paraphimosis include:
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Inability to pull the foreskin forward over the head of the penis.
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Swelling of the end of the penis.
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Pain and tenderness.
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Turning color.
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Problems with urinating.
How is paraphimosis diagnosed?
A physical exam is enough to diagnose paraphimosis.
How is paraphimosis treated with surgery?
Paraphimosis can be treated by reducing swelling of the penis. Then your doctor will press on the head of the penis while pushing the foreskin forward.
If this doesn't work, surgery may be done to release the foreskin. Either a slit incision on the foreskin or a full circumcision may be done. Some swelling is normal during the first few days after the procedure. A clear or reddish crust will likely form over the area. It normally takes 7 to 10 days for the penis to heal.
What are possible complications of paraphimosis?
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:
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Damage to the penis tip.
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Gangrene.
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Loss of the penis tip.
Can paraphimosis be prevented?
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Returning the foreskin to its normal position after pulling it back may help prevent this condition.
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Circumcision, when done correctly, prevents this condition.
Home care
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If you have any light scratches or tears to the foreskin, apply an antibiotic ointment, such as bacitracin.
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Avoid retracting the foreskin for 1 week and stay away from any activities that could make the condition worse.
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Understand if and when the doctor wants you to start retracting the foreskin again.
Follow-up care
See your child's doctor in the next 2 days for a wound check, or as advised. If the paraphimosis was reduced without surgery, talk with the doctor about ways to prevent it from happening again.
When to contact your child's doctor
Contact your child's doctor if:
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There's a blood stain in your child's diaper.
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Your child has redness or swelling of the penis.
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Your child has pain when peeing.
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Pus or fluid is draining from the incision.
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Your child has a fever of 100.4°F (38°C) oral or 101.4°F (38.5°C) rectal, or higher in an adult or older child, or as advised by the doctor. Also call for any rectal temperature of 100.4° or higher in an infant 3 months or younger.
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Your child has less urine flow.
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Your child vomits.
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You're worried about your child's penis or are unsure of the correct care.
