Paraphimosis

Paraphimosis is the inability to pull forward a foreskin that has been retracted behind the glans penis. Oedema and congestion develop in the glans and prepuce to exacerbate the difficulty.

• Paraphimosis can occur at any age.
• Elderly men are commonly affected when the foreskin is not correctly pulled forwards after retraction for catheterisation.
• Children and adolescents may be affected when experimenting with foreskin retraction or when they fail to reduce the foreskin after voiding or bathing (1).

Patients with paraphimosis often presents with substantial pain and penile swelling, hence it should be regarded as a medical emergency (1).

Treatment

• manual reduction after applying local anaesthetic jelly as a lubricant and to relieve pain.
• in difficult cases, a dorsal slit should be made in the foreskin (1)
• circumcision should be performed once the oedema and inflammation have resolved.

Reference:

• (1) McGregor TB et al. Pathologic and physiologic phimosis. Can Fam Physician 2007;53(3):445-448