Paraphimosis : A guide to Circumcision

Paraphimosis is a serious condition in which the foreskin of the penis is retracted to the extent that it becomes trapped underneath the glans (head of the penis). This acts as a tourniquet around the glans which results in pain and discomfort plus the foreskin cannot be pulled back into its original position.

This causes severe swelling around the penis and pain during an erection. This swelling can obstruct the blood supply to the penis which if left untreated, will cause this tissue to deteriorate and eventually die.

It is an uncommon disease and occurs less frequently than phimosis.

Symptoms of paraphimosis

These include:

• Noticeable swelling around the foreskin and glans
• Severe pain especially on erection
• Formation of ulcers

Plus babies and young boys may find that they experience problems with urination.

Causes of paraphimosis

There are several causes of paraphimosis which include:

• Infection
• A side effect of penile ring piercing
• Urinary catheterisation
• Examination of the penis
• Cytoscopy ( the insertion of a camera mounted tube into the bladder via the urethra)
• Injury to the penis

Many of these occur if the foreskin is retracted for a long period of time, e.g. penile examination.

Treatment for paraphimosis

Paraphimosis is serious and requires immediate attention. The danger here is that constriction of the foreskin will block the blood supply to that area and lead to tissue death (gangrene).

There are two ways of treating this: surgically or non-surgically.

There are two forms of surgery which include:

• Minimally invasive surgery to reposition the foreskin (back to its original position)
• Circumcision

Then there are non-surgical options which include:

• Medication to reduce the swelling
• Pressing the glans and at the same time, releasing the trapped foreskin.

Complications of paraphimosis

If this condition is left untreated it can lead to complications such as:

• Damage to the glans which may require amputation
• Gangrene caused by tissue death in the glans

Paraphimosis can recur but circumcision is effective at preventing this from happening.