Phimosis and Paraphimosis (Penis Disorders)

  • Medical Author:
    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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What is the definition of paraphimosis?

Paraphimosis occurs when the foreskin is retracted behind the glans penis and cannot be returned to its original position. This turns into a urologic emergency as blood flow is decreased to the glands penis.

What causes paraphimosis?

Paraphimosis is an uncommon condition usually inadvertently caused by retraction of the foreskin by the individual, or in a hospital or nursing home setting by a healthcare professional inserting a Foley catheter, or preparing the patient for a procedure.

What are the symptoms of paraphimosis?

Once the skin is trapped, edema occurs and the restriction worsens, often forming a very tight tissue ring. This causes pain and worsening swelling (edema).

How is paraphimosis diagnosed?

Your doctor will diagnose paraphimosis based on a thorough history and the physical examination. Additional tests are usually not necessary.

What is the treatment of paraphimosis?

Manual reduction is usually the first treatment option. To help with the pain, your doctor might apply a local anesthetic cream, give you pain medication by mouth, or apply a local anesthetic block to your penis.

Applying ice to the local area can help with the edema during manual reduction.

Local injection of hyaluronidase is effective in decreasing the swelling and allowing reduction.

If none of the above techniques are successful or if the doctor feels a faster reduction is necessary, a small surgical slit can be made in the back side (dorsal region) of the constrictive skin. This should usually be followed by a circumcision at a later date to avoid a recurrence.

Medically Reviewed by a Doctor on 3/23/2016

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