Definition:
Paraphimosis pertains to a rare condition characterized by the foreskin becoming trapped behind the glans penis. Once pulled back behind the glans penis, the foreskin cannot be brought down to its normal flaccid position covering the glans penis.
Diagnosis:
Paraphimosis is easily diagnosed on the basis of the sight of the trapped foreskin.
Treatment:
Mild paraphimosis can be manipulated by compressing the glans penis and then moving the foreskin back to its normal position, often with the help of a lubricant. If this doesn't work, a dorsal slit procedure or circumcision may be done. The Dundee technique, an alternate method in which multiple punctures are placed in the swollen skin and then expressing the edema fluid with manual pressure, may also be done. If untreated for too long, paraphimosis can lead to necrosis of the glans penis, at which point partial amputation of the distal penis is almost invariable necessary.
Symptoms and Signs:
The primary symptom of paraphimosis is foreskin that is trapped behind the glans penis. Other than this main characteristic, paraphimosis rarely presents with symptoms. When it does become symptomatic, paraphimosis presents with penile pain and obstructive voiding symptoms. Upon examination, the glans penis may appear swollen, enlarged, and congested with a collar of edematous foreskin. The rest of the penile shaft may look normal. If untreated, paraphimosis can lead to necrosis of the glans penis, which may ultimately need partial amputation.
Causes:
Paraphimosis is caused by the act of pulling the foreskin back behind the head of the penis for an extended period of time. In most cases, this is caused by well-meaning doctors or healthcare professionals when doing a penile examination or urethral instrumentation.
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