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Highlights & Basics
- Paraphimosis is a condition caused when the foreskin of an uncircumcised penis is retracted and left behind the glans, leading to vascular engorgement and edema of the distal glans.
- In its acute form, it is a medical emergency requiring rapid evaluation and possible surgical decompression.
- Can occur at any age but is most common in children and older people.
- Circumcision is preventative and is curative if the process develops.
- Most cases are iatrogenic in etiology.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Diagram illustrating paraphimosis
Paraphimosis
Paraphimotic ring
Diagram illustrating the technique for manual reduction of paraphimosis
Prereduction of paraphimosis
Process of manual manipulation of paraphimosis
Dorsal slit for management of paraphimosis
Dorsal slit for management of paraphimosis
Completed dorsal slit and reduction of the paraphimosis
Citations
European Association of Urology. Paediatric urology. Mar 2022 [internet publication].[Full Text]
Manjunath AS, Hofer MD. Urologic emergencies. Med Clin North Am. 2018 Mar;102(2):373-85.[Abstract]
British Association of Paediatric Urologists. Management of foreskin conditions. 2017 [internet publication].[Full Text]
1. McGregor TB, Pike JG, Leonard MP. Pathologic and physiologic phimosis: approach to the phimotic foreskin. Can Fam Physician. 2007 Mar;53(3):445-8.[Abstract][Full Text]
2. European Association of Urology. Paediatric urology. Mar 2022 [internet publication].[Full Text]
3. Manjunath AS, Hofer MD. Urologic emergencies. Med Clin North Am. 2018 Mar;102(2):373-85.[Abstract]
4. Rangarajan M, Jayakar SM. Paraphimosis revisited: is chronic paraphimosis a predominantly third world condition? Trop Doct. 2008 Jan;38(1):40-2.[Abstract]
5. Williams JC, Morrison PM, Richardson JR. Paraphimosis in elderly men. Am J Emerg Med. 1995 May;1(3):351-3.[Abstract]
6. Manjunath AS, Hofer MD. Urologic emergencies. Med Clin North Am. 2018 Mar;102(2):373-85.[Abstract]
7. Choe JM. Paraphimosis: current treatment options. Am Fam Physician. 2000 Dec 15;62(12):2623-6, 2628.[Abstract][Full Text]
8. Abara EO. Prepuce health and childhood circumcision: choices in Canada. Can Urol Assoc J. 2017 Jan-Feb;11(1-2 suppl 1):S55-62.[Abstract][Full Text]
9. Lee B, Vangipuram R, Petersen E, et al. Complications associated with intimate body piercings. Dermatol Online J. 2018 Jul 15;24(7).[Abstract][Full Text]
10. Verma S. Coital penile trauma with severe paraphimosis. J Eur Acad Dermatol Venereol. 2005 Jan;19(1):134-5.[Abstract]
11. Ramdass MJ, Naraynsingh V, Kuruvilla T, et al. Case report. Paraphimosis due to erotic dancing. Trop Med Int Health. 2000 Dec;5(12):906-7.[Abstract]
12. Yiqiter M, Arda IS, Hicsonmez A. An unusual cause of paraphimosis: hemangioma of the glans penis. J Pediatr Surg. 2008 Feb;43(2):e31-3.[Abstract]
13. Reynard JM, Barua JM. Reduction of paraphimosis the simple way - the Dundee technique. BJU Int. 1999 May;83(7):859-60.[Abstract]
14. Palmisano F, Gadda F, Spinelli MG, et al. Glans penis necrosis following paraphimosis: a rare case with brief literature review. Urol Case Rep. 2017 Nov 13;16:57-8.[Abstract][Full Text]
15. Kato T, Mizuno K, Nishio H, et al. Can lichen sclerosus be diagnosed by preputial appearance or symptoms? Res Rep Urol. 2018 Sep 18;10:89-94.[Abstract][Full Text]
16. Berk DR, Lee R. Paraphimosis in a middle-aged adult after intercourse. Am Fam Physician. 2004 Feb 15;69(4):807-8.[Abstract][Full Text]
17. Tsai SL, Reynoso E, Shin DW, et al. Acupuncture as a nonpharmacologic treatment for pain in a pediatric emergency department. Pediatr Emerg Care. 2018 Sep 21 [Epub ahead of print].[Abstract]
18. Turner CD, Kim HL, Cromie WJ. Dorsal band traction for reduction of paraphimosis. Urology. 1999 Nov;54(5):917-8.[Abstract]
19. British Association of Paediatric Urologists. Management of foreskin conditions. 2017 [internet publication].[Full Text]
20. Kerwat R, Shandall A, Stephenson B. Reduction of paraphimosis with granulated sugar. Br J Urol. 1998 Nov;82(5):755.[Abstract]
21. Barone JG, Fleisher MH. Treatment of paraphimosis using the "puncture" technique. Pediatr Emerg Care. 1993 Oct;9(5):298-9.[Abstract]
22. DeVries CR, Miller AK, Packer MG. Reduction of paraphimosis with hyaluronidase. Urology. 1996 Sep;48(3):464-5.[Abstract]
