Paraphimosis is the inability to reduce a swollen foreskin over the penis glans and is a relatively common disease that just occurs in men and can lead to a lot of annoying issues with mild to severe symptoms. Thus, it should be prevented and treated in time.

It is a urologic emergency, a disease that can affect only uncircumcised males. It occurs when the foreskin cannot be pulled forward over the penile tip any more. This makes the foreskin stuck and swollen, which can stop or slow down the blood flow to the penile tip.

Causes And Symptoms Of Paraphimosis:-

Paraphimosis is well-known to be iatrogenic, happening as the medical staff forgets to reduce the foreskin after catheterization or instrumentation of the urethra. The foreskin would not become entirely mobile before a boy reaches three or four years of age, causing the paraphimosis issue in boys under 3 or 4 years as their caregivers retract their foreskin to clean.

Patients will have to suffer from a swollen, painful, and red glans penis associated with a proximally retracted, edematous foreskin that appears with a circumferential constricting band. The shaft proximal of the penis to the constricting band is often soft.

Paraphimosis can happen even after a sexual activity, an erection, or even due to an injury affected the penis’s head. A patient with paraphimosis will notice his foreskin stuck behind the ridge of the penis head. If this situation is prolonged, it forces patients to suffer from extreme swelling and pain, and it can even weaken the blood flow to the penis. In severe situations, the low blood flow can lead to gangrene (the death of tissue), and patients may even have to accept the penis amputation.

Causes:-

There are many factors that can force people to suffer from paraphimosis and many people even do not notice some in their daily life. The major causes of this terrible and stubborn disease may include:

• Have a foreskin that has been pulled back for a long time
• Have a foreskin that is tighter than usual
• The foreskin is overly pulled back
• Experience physical trauma to the genital region
• Have an infection

Initial Treatment:-

Treatment depends on the age of the patients plus the resulting symptoms and the severity of the case as well.A steroid ointment could be locally applied as the very first choice of treatment for this condition. This cure comes with a success rate of more than 70%. The ointment will help to soften the foreskin and will be applied for 1 to 2 months. The ointment would be discontinued once the full retraction is possible. If the steroid ointment method is not successful, it will be more beneficial to take a more powerful treatment, and this also depends on other factors – the underlying signs and symptoms.

Symptoms:-

There are several signs and symptoms that patients will notice as they suffer from paraphimosis –

• Tenderness
• Swollen glans (the penis’s shaft is not swollen)
• Redness (erythema)
• Penile pain
• Urinary retention (inability to urinate)
• Indicates necrosis (black tissue on the glans)
• Band of the retracted foreskin tissue beneath the penis’s glans

Signs And Symptoms Of Paraphimosis:

• White ring: The foreskin’s opening has a white ring that appears with the look as a scar tissue.
• Foreskin pain: the patients will notice that their foreskin hurts. It could also appear with discharge as well.
• Infections: The patients can notice one or more urinary tract infections. Symptoms may include the urge to go even as the bladder has nothing to release, burning or pain when you pee, blood in the urine, and pressure or pain in the back or lower abdomen at the same time.
• Pain: When the patients have sex, it could be painful when the patients have any erection. In the bathroom: the foreskin of the patients would be expanded as the patients pee, seeming like a balloon. It could also lead to pain.
• Blood: Patients could even notice blood in the toilet or in the stream. The stream could appear weaker than normal.

If you are suffering from any of these signs and symptoms, be careful; and it would be best for you to go to the medical center and take a small test!

Care:-

Sometimes the foreskin could go back into its position naturally. Nevertheless, the medical provider may have to create a slit in the foreskin to reduce some pressure. It is often suggested removing foreskin (circumcision) for patients that are affected by this condition. In uncircumcised infants, the foreskin is often very tight. It often does not start to loosen enough to pulling back till the child reaches 18 months of age at least. Till then, do not touch the foreskin or make any interference. Later, parents can pull the foreskin of the babies back gently during bathing.  When suffering it is advisable to –

• Avoid sex for seven to ten days.
• Stop pulling back your foreskin till after the follow-up visit.
• Use over-the-counter medicines for pain management such as ibuprofen, acetaminophen, and aspirin. You can ask your doctor for additional medications.
• To reduce swelling, try applying ice packs to the penile area.
• If your doctor slits your foreskin, keep the dressing dry and clean and keep it in place till your next meeting with your doctor.
• Inject hyaluronidase– a powerful enzyme that can help to relieve swelling
• Use a syringe to drain blood or pus
• Use a bandage to tightly wrap around your penis

Complications:

Paraphimosis can also contribute to causing several severe complications if it is not cured in time. The disease can lead to reduced penis’s blood flow, which can deprive the tissue of oxygen. When it occurs, this disease can lead to:

• Tissue death (gangrene), causing the loss of the penis’s tip
• Damage to the penis tip
• Severe infection

Risks:-

There are many factors that can increase your risks of developing paraphimosis and you really need to deal with and avoid them as soon as and as carefully as possible –

• Past injury: This includes every direct injury that the penis has to stand that can leave scars on the area. Scars could make it difficult for your foreskin to go back to the true position.
• Infection: An infection in the urethra (tube in the penis that allows urine to pass through) or under the foreskin can lead to inflammation.
• Poor Hygiene: Urine, smegma, and other substances could be “collected” under the foreskin and force patients to suffer from a sense of irritation or infection. Smegma is the waxy, white substance that the body makes to keep the penis’s head soft and smooth. It is necessary and crucial for keeping the penis always in good hygiene under the foreskin.

Phimosis: –

Some males are born with a tight, small foreskin’s opening. This disease is known as phimosis.

Contact a professional or doctor if –

• You have any question or concern about how to care or cure your paraphimosis effectively.
• You notice painful feelings during sexual activities.
• Your symptoms and signs reoccur or become worse

Treatments:-

In fact, paraphimosis can go away on its own. The swelling that appears along with the penis when the disease occurs will be reduced after the foreskin has returned to the original position it used to have. Manual reduction is often the very first choice for patients when it comes to treatments for paraphimosis.

Surgery:–

This is the very first one on the list of common treatments for paraphimosis people should know. This is actually the very last thing to do if any other treatment or technique cannot work well. Doctor would use tools to lead to foreskin to come back to its proper position and the matter would be solved fast. As you see your penis’s swelling becomes severe, a cut would be made through the top of your foreskin. This would help to release the swelling and pressure. After this procedure, patients could need a circumcision as cutting the foreskin would be able to change the whole appearance of the penis.

Puncture technique:-

To make this, the doctor or medical expert will create one or more small holes in the foreskin for releasing all fluids’ buildup. For serious penis swelling, people need to drain out all trapped blood of the penis.

Manual reduction:–

As the penis’s swelling due to the condition relieves, the medical expert or doctor will try to move the patients’ foreskin back into the position over their glans. The doctor would use just slow, steady pressure to push the glans into the foreskin.

Sugar:–

This is also a common treatment for paraphimosis that people should try. Doctors would put sugar water on the gauze pressure bandage and apply onto the sicked penis. Sugar can aid a lot in drawing out all fluids from the penis’s swollen region.

Pressure:–

A doctor or health expert can also choose tightly squeezing the penis of patients within a relatively short time period. This can aid a lot in decreasing signs and symptoms of inflammation. Doctors will use a bandage to wrap the patients’ penis within five to ten minutes. Doctors can also use a bandage with numbing medicines.

Ice:–

Sometimes, patients can also receive an ice pack placed on their glans and foreskin within five to ten minutes to reduce signs and symptoms of inflammation. Using ice to apply directly onto the painful area to help with the edema during the manual reducing process is also one of the most common things that the medical healthcare provider will apply.

Pain Medicine:-

Doctors can also put a numbing cream onto the patient’s penis to reduce pain fast and effectively. Doctors or medical experts will inject one of some local numbing medicines if the patient needs a procedure to cure the paraphimosis issue fast. Local injection of hyaluronidase is also very useful for reducing the senses of pain and swelling, allowing patients to get quick relief from the signs and symptoms.

Prevention:-

Paraphimosis can a pretty harmful disease as it can lead to several related issues as mentioned above, but there are still some useful and simple methods that people can make use to prevent its occurrence, including:

• Never leave the foreskin behind your penis’s tip for a long time period
• Ensure to remind the medical personnel to pull back your foreskin to its normal position after any procedure or exam.
• Always place your foreskin back over the penis’s tip after pulling it back for urination, sexual intercourse, or cleaning
• Practice good hygiene and clean your penis’s tip on a regular basis to keep it healthy.