Phimosis and Paraphimosis Treatment

Phimosis is the inability to retract the foreskin behind the head (glans) of the penis. Some of the symptoms include

  • Painful erection
  • Pain during urination
  • Pain in penis
  • Blood during urination

Phimosis can be physiological or pathological. Physiologic phimosis is the normal condition in which children are born with a tight foreskin and separation occurs during late childhood and early adolescence. Pathologic phimosis occurs due to infection, inflammation, or scarring and is usually found in uncircumcised adult men.

Treatment for phimosis

Treatment depends on the age, severity and resulting symptoms of the procedure.

  • In most cases, the phimosis is treated by steroid ointment applied locally. Usually, the success rate is above 70% for this method. Once full detraction is attained then ointment is discontinued.
  • If the steroid ointment treatment is not successful, then circumcision can be beneficial.

Paraphimosis

This is opposite of phimosis. This occurs when the foreskin is retracted behind the glans penis but cannot return to its original position. This is an emergency condition.

  • The swelling can lead to blockage of blood flow to the penis. This can lead to gangrene of the penile shaft and head.

Circumcision at birth or revision of a prior circumcision can help prevent this condition.

Other than this, any condition or activity that results in prolonged foreskin retraction can lead to development of paraphimosis.

  • Excessive and vigorous sexual activity, including masturbation
  • Frequent insertion of bladder catheters
  • Males forgetting to return the foreskin to its normal position after retracting it

Treatment of paraphimosis

Paraphimosis is an emergency condition which needs an immediate clinical attention.

  • Manual reduction with a local anesthetic is usually the first treatment option. 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 the above methods do not work, then a small surgical slit is made on the dorsal side (back side). A circumcision is done by a urologist or an andrologist to avoid recurrence.

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