Paraphimosis is without doubts one of the urgent conditions in urology. It is a less common but a dangerous situation when narrowed foreskin is pulled over the glans of penis, but it gets stuck and can not be mechanically put back.


The most common cause is narrowed foreskin (phimosis) that is however wide enough to allow movement of the foreskin over the glans. The paraphimosis usually occurs during a sexual intercourse or masturbation. However, it may also occur in hospitals in catheterization of male patients. During this procedure, the foreskin is usually dragged over the glans to allow the medical staff to insert the catheter into the urethra. If the foreskin is left in this position, it can easily swell and lead to development of paraphimosis.



Scheme - penis with paraphimosis



The main problem occurs when the narrowed foreskin strangles the penis glans. This is a serious situation as the strangulation may stop the blood flow with nutrients and oxygen to the tissue of the glans. The penis is painful; it becomes swollen and turns reddish or purplish. If the situation is not solved in time, there is a risk of irreversible damage including tissue necrosis.


The victim must seek help as soon as possible. The diagnosis is quite easy for a skilled urologist who sees the strangulated penis and non-retractable swollen foreskin.


The urologist may try to pull the foreskin back over the glans manually by using a variety of moisturizing gels or ointments. If the manual reposition is not possible, the condition must be solved surgically by cutting the foreskin followed by classic circumcision.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources