Paraphimosis: A gender biased disease
Paraphimosis, is a gender biased disease that affects male population. It is a serious condition where the foreskin above the penis stays behind the head of the penis (glans) and is not able to pull itself above the glans of the penis, as it usually is in normal position. This retraction of the foreskin occurs due to many reasons, which will be discussed in the coming part of the article. This retracted foreskin sometime functions as tourniquet causing the glans penis to swell worsening the constriction, and further blocking the blood supply and preventing foreskin from returning back to its normal position. Paraphimosis is very common in uncircumcised (haven’t had their fore-skin removed) males and boys. Paraphimosis is a serious medical problem, which should be attended at the earliest or may result in sustain long term or permanent damage to penis.
Paraphimosis is caused due to several reasons. It can be a result of injury to the penis or foreskin, infections or poor hygienic conditions. Failure to pull the foreskin back to its normal position after urination, bath or sex may also result in paraphimosis. In addition, if the doctor or nurse fails to pull back the foreskin of a patient to normal position after physical examination or catheterization, the foreskin may get retracted. Uncircumcision or improper circumcision can lead to paraphimosis. Prolonged pulled back condition of foreskin may result in swelling, ultimately paraphimosis.
Paraphimosis manifests as inability to pull back the foreskin over the glans penis, accompanied by pain in the penis and swelling of the glans penis. There could be a change in color of the penis to dark red or bluish color due to poor blood supply. It may be difficult to pass urine. Paraphimosis may also manifest as penile infection.
A simple physical examination confirms paraphimosis. The urologist usually looks for the band of skin that tightens itself behind the head of the penis (glans penis). Always after diagnoses of paraphimosis try to know from your urologist whether there are any underlying causes as there are high chance of mis-diagnosis.
A milder form of paraphimosis can be effectively treated that the severe forms.
Manual reduction is one of the treatment options. Pulling back the foreskin over the glans is possible only after reducing the inflammation. Swelling is reduced by placing ice in the swollen area or by wrapping the swollen area with tight bandage for 5-7 minutes or by gently putting pressure on the glans so that the blood from the glans moves out reducing its size. Once the swelling seems better you can now gently try pulling the retracted foreskin over the glans.
A shot of Hyaluronidase enzyme may help to reduce swelling. In addition, the swollen region may be punctured many times using a hypodermic needle, so that the trapped fluid is drained out . Another method to reduce the swelling is to use osmotic agents, such as simple sugar, which absorbs the fluid content inside the penis and reduces swelling.
If in case, all the above said treatment procedure fails, the doctor may finally go in for a minor surgery that involves making a small slit in the foreskin to loosen it a bit and bring it back on the glans penis. In severe cases, circumcision is done and the whole foreskin is removed. This is very effective technique as the chance of recurrence is nil.
Like any disease, paraphimosis in its severe condition may have very serious complications. Similarly, severe untreated paraphimosis may result in complications like
- Complete loss of penile circulation (gangrene)
- Amputation of penis
- Permanent damage to the penile tip
- Loss of glans penis
Paraphimosis can be prevented by practicing healthy penile hygiene to keep infections away. The fore skin should be pulled back to its normal position after a detailed penile examination by the physician or after sexual intercourse or after using the bathroom. The fore skin should never be left behind the head of the penis for a longer time than required. After catheter insertions, it should be ensured that the fore skin is pulled back to its normal position (over the head of the penis). Circumcision, if done correctly, prevents paraphimosis.
As said “Prevention is better than cure” you can prevent the serious complications of paraphimosis by just following few simple hygienic tips. Remember to minimize the use of instruments on the penis. Changing your life-style and living a highly improved life can help you stay away from many such hygiene related diseases.