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Paraphimosis

Last Updated October 2023 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

What is paraphimosis?

Paraphimosis is a serious condition that can happen only to people who have penises and who haven’t been circumcised. (Circumcision is when the foreskin of the penis is removed, usually in the first few days after birth.) Paraphimosis happens when the foreskin gets stuck behind the head of the penis. It can’t be pulled back down into a normal position.

Paraphimosis can happen to any uncircumcised penis. It is most common in younger and older people. It is a medical emergency and needs to be treated quickly.

Symptoms of paraphimosis

The main symptoms of paraphimosis include:

  • Not being able to pull the foreskin back to its normal position
  • Swelling of the end of the penis
  • Discomfort and pain

Other symptoms could include:

  • Redness and tenderness
  • Trouble urinating

If you can’t pull your foreskin over the head of your penis, you should call your doctor right away.

What causes paraphimosis?

Uncircumcised people sometimes pull the foreskin back during sex, when they go to the bathroom, or when they clean their penises. Doctors and nurses might pull the foreskin back when they examine the penis or put in a catheter.

Sometimes you, a doctor, or a nurse might forget to pull the foreskin back down. If the foreskin is left behind the head of the penis too long, your penis might swell so much that the foreskin is trapped behind it.

Other causes of paraphimosis:

  • An infection. This can happen when the area is not washed well.
  • An injury to the area. Injury can happen from vigorous sex, a piercing, scarring from repeated infection, or an insect or spider bite.
  • A circumcision that wasn’t done correctly.
  • Diabetes, which can cause chronic inflammation of the penis and foreskin.

How is paraphimosis diagnosed?

There are no tests required to diagnose paraphimosis. Your doctor will do a physical exam and look at your or your child’s penis to diagnose it.

Can paraphimosis be prevented or avoided?

The only way to completely prevent paraphimosis from happening is by being circumcised. If you are not circumcised, you can still avoid paraphimosis by:

  • Always pulling the foreskin back down to its natural position. This could be after having sex, going to the bathroom, or cleaning yourself.
  • Never leaving the foreskin behind the head of your penis for any longer than you need to.
  • Checking to be sure that the foreskin is covering the head of your penis after a catheter is put into your bladder.

Paraphimosis treatment

The first thing your doctor will do is treat the swelling. This can be done by pressing your penis with a hand, wrapping your penis in a tight bandage, or using ice. After the swelling has gone away, your doctor should be able to pull the foreskin back down. If the foreskin remains stuck, your doctor might need to make a small cut in the trapped foreskin to loosen it. In some cases, your doctor may need to do a circumcision.

Living with paraphimosis

If paraphimosis is diagnosed and treated quickly, you shouldn’t have any other problems. If the condition is left untreated, it can cause complications. It could disrupt blood flow to the tip of the penis. Though rare, this could lead to damage to the penis tip, gangrene, or loss of the penis tip.

Questions to ask your doctor

  • What is the best treatment for me?
  • How long will it take before the swelling in my penis goes down?
  • How long will it be before the cut in my foreskin heals?
  • Is there anything I can do at home to stop this from happening?
  • Is it safe to have sex soon after I’m treated?

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