Paraphimosis is the inability to bring the excess skin taken back to its original position after being pulled back to the back of the glans penis, and the glans of the penis is compressed and the blood circulation is impaired. This impingement and circulatory disturbance can be severe enough to cause necrosis of the glans penis. Compared to phimosis, it is a more acute and urgent condition.
It often occurs when a family member does not return the foreskin to its natural position for cleaning purposes or after a well-intentioned healthcare professional’s penis examination or after catheterization of the urinary bladder.
The treatment is to return the skin to its original position under general anesthesia. Since the swelling can cause enough difficulty in reducing the skin on the glans (penis head), gentle pressure can be applied to the skin to reduce the swelling to open the paraphimosis. A short-term application of ice to the area before pressure is applied may be beneficial in terms of its analgesic effect. After the swelling subsides, the head of the penis is pushed with the thumb, while the skin is pulled with the other fingers. After paraphimosis, edema may occur to a degree that cannot retract the foreskin, in which case more advanced surgical techniques should be used.
In severe cases, a Pediatric Surgeon may surgically make a small incision in the foreskin to release the glans. If this fails, immediate surgical circumcision will be needed.
