Paraphimosis: what is it, causes, symptoms and treatment

• Paraphimosis is a complication of phimosis, which involves strangulation of the head of the penis due to the inability to retract the foreskin to its normal position.
• Paraphimosis is a urological emergency that requires circumcision to completely eliminate all symptoms associated with the disease.
• Circumcision is an operation that takes 20 - 30 minutes, on an outpatient basis, so that the patient will be able to return home at the end of the surgery on his own foot.

Paraphimosis or painful swelling of the foreskin occurs when the foreskin is retracted behind the glans or head of the penis and cannot return to its normal position. This situation presents a high level of severity due to the understanding of the penis, which will not allow the drainage of blood.

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Paraphimosis is common in both boys and men who have not been circumcised, i.e. the foreskin has not been removed, or when the tissue has not been completely removed during the circumcision.

Paraphimosis occurs most often in older men and children

This pathology is considered a medical emergency that needs to go to a hospital as soon as possible. 

Paraphimosis is usually given as a complication of phimosis, being more serious and dangerous since it involves strangulation of the penis which, in the worst case, could cause a necrosis due to congestion that impedes blood flow. 

Therefore, paraphimosis presents a different emergency condition from phimosis.

Thus, it is essential to make a comparison in these two pathologies. What makes one different from the other? Below you can read the differences between phimosis and paraphimosis.

First of all, phimosis is a disease that usually develops in newborn children and, in most cases, is corrected naturally before they reach the age of 3. However, some of them require medical intervention, i.e. circumcision. But in what cases is circumcision necessary?

This surgical intervention is performed in both urological circumstances: phimosis and paraphimosis. However, paraphimosis is a major emergency, as it is a complication of phimosis. Thus, phimosis and paraphimosis are distinguished as follows:

• Phimosis: is the narrowness of the foreskin, that is, the skin that covers the penis prevents it from retracting above the tip of it. As we were telling you, it's a very common disease in newborns. In 90% of those cases, when the child reaches the age of 3 years, the skin adheres to the tip of the penis, allowing normal and painless retraction. However, in some cases the slipping of the foreskin in a state of flaccidity is not achieved, requiring a visit to the doctor and, in quite a few cases, phimosis surgery.

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Some factors that contribute to the onset of the disease are poor hygiene or insufficient hygiene. This can lead to infections and make it a problem for future sex. 

On the other hand, it is common for some mothers to remove the skin of the newborn's foreskin backwards to prevent phimosis. This should be done carefully and gently because, if done abruptly at too early an age, it may cause a fibrous wound and scar in the child that will lead to greater adherence to the foreskin.

In any case, it will be the doctor who indicates the suitability of this maneuver and determines its correct execution.

• Paraphimosis: is a complication of phimosis. As you may have read, phimosis means that the skin surrounding the glans is too narrow to easily come down and leave it exposed. When suffering from paraphimosis, the foreskin retracts below the glans and prevents the skin from returning to its initial position. Therefore, paraphimosis involves strangulation of the foreskin after uncovering the glans, that is, the head of the penis.

The consequence of suffering from paraphimosis is the appearance of edema and severe pain in the area

This can lead to a number of very serious symptoms such as penile necrosis, due to blood insufficiency, as well as an increased risk of infections.

Paraphimosis is a complication of phimosis, or a subsequent consequence of it. Therefore, it is essential to know when you have phimosis in order to act in time before it. Some of the most common symptoms of phimosis are:

• Difficulty retracting the glans and exposing it.
• Pain when you lower the skin around the glans.
• Pain when having an erection and during sex.
• Inflammation of the foreskin when urinating and decrease in the intensity of the jet.
• Itching in the area or presence of white plaques due to poor hygiene.

If you have any of the symptoms listed above, it is important that you see your doctor so that the problem can be diagnosed and an effective solution can be proposed.

However, paraphimosis may develop as a result of other situations. In the following section you will be able to know the causes of this pathology, being more common in men who have not been circumcised, or in those who have not been circumcised correctly.

• Injury. A mishandled medical procedure can lead to paraphimosis. Usually, when we talk about this cause, we are referring to the placement of a catheter to drain urine or when performing an endoscopy.
• Failure to return the foreskin to its normal state after urinating, after washing the penis or after sexual intercourse. This can lead to paraphimosis with the difficulty or even impossibility of returning the skin to its normal location.
• Poor hygiene. Failure to wash the area properly can lead to infection of the foreskin and cause paraphimosis.
• Paraphimosis can also occur after an infection or balanitis, i.e. inflammation of the glans penis, accompanied by a lot of pain.

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These causes are more likely to cause paraphimosis in men who have not been circumcised or have not been circumcised in the correct way. Therefore, it is important that if you have not been circumcised, you should be aware of the symptoms of phimosis, mentioned above, so that you do not suffer a later complication such as paraphimosis.

In addition, to avoid paraphimosis, you can counteract the most common causes of the condition, but how? In the following section we tell you how you can contribute to the health of your penis.

• Regarding medical procedures via probes, catheters or endoscopies, try to make sure that the foreskin covers the head of the penis.
• Regarding the position of the foreskin, be sure to return it to its normal position after sexual intercourse, wiping or urination.
• Do not leave the foreskin behind the head of the penis longer than necessary.

If you have not followed the recommendations throughout your life to avoid paraphimosis or if you have suffered from any symptoms of phimosis, you are more likely to suffer from this medical problem.

Paraphimosis involves strangulation of the foreskin. As the preputial skin retracts behind the tip of the penis, the foreskin and glans swell, resulting in the following symptoms:

• Inability to pull the foreskin back over the head of the penis.
• swelling and pain in the penis
• Blackened glans or head of the penis due to strangulation and lack of blood supply.
• Difficulty or even inability to urinate or ejaculate due to pressure on the closure of the urinary canal.

The most visible symptom of paraphimosis is swelling of the penis.

As we have already mentioned, paraphimosis has a higher emergency status than phimosis, so the main recommendation after suffering any of these symptoms is to visit the doctor urgently. In most cases, the doctor will recommend surgical treatment, i.e. circumcision to solve the problem of paraphimosis.

Circumcision is a simple operation, after which it is completely impossible to suffer from paraphimosis because the skin over the penis is completely removed.

Surgery for paraphimosis or circumcision is performed to solve the problems related to this condition definitively. This operation lasts 20 to 30 minutes and is performed under local anaesthesia, so you will be awake during the operation. 

For your peace of mind, you will not feel any pain or discomfort in the operated area. In fact, as it is an outpatient surgery, you will be able to go home after the operation.

Circumcision for paraphimosis involves the following:

• After placing you on the stretcher, facing upwards and with your legs open and elevated, you will be covered with a surgical sheet so that only the penis area is uncovered.
• The penis will then be washed and disinfected before the anaesthetic is applied to the area. Once the anaesthetic has taken effect, the circumcision will begin.
• First, the surgeon will cut away the excess foreskin and stitch up any stitches that are needed.
• After that, the area will be bandaged and the medical or nursing team will explain the post-operative care.

At the end of the surgery, you will be taken to a room so that you can get dressed and go home on your own, although we recommend that you are accompanied. 

The doctor will prescribe you some painkillers to avoid pain and will advise you to follow a correct postoperative period to help your recovery.

Circumcision is the only solution in cases of paraphimosis.

Operarme has the collaboration of different private hospitals nationwide to carry out circumcision for paraphimosis. The aim is to solve your medical problems in the most comfortable and effective way possible.

For this reason, we offer you a free initial surgical assessment consultation with the specialist to determine the need for surgery in your case of phimosis or paraphimosis. It is important that you provide all the tests you have had previously so that the doctor can make a more accurate diagnosis. 

This is not a diagnostic consultation, but rather a surgical assessment to give you the patient's approval for circumcision.

The patient service team at Operarme will inform you of all this and will answer any questions you may have. If you would like to request this free assessment consultation, you can do so by calling at +34 91 141 33 56 or by clicking on the following image:

Do you need phimosis surgery?

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