Presentation
History
Adult patients with symptomatic paraphimosis most often report penile pain. In the pediatric population, paraphimosis may manifest as acute urinary tract obstruction and may be reported as obstructive voiding symptoms.
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Physical Examination
On examination, the glans penis is enlarged and congested with a collar of edematous foreskin. A constricting band of tissue is noted directly behind the head of the penis. The remainder of the penile shaft is unremarkable. An indwelling urethral catheter is often present. The image below depicts mild-to-moderate paraphimosis.
Mild-to-moderate form of paraphimosis. The treatment involves manual reduction, puncture technique, or medical therapy.
If paraphimosis is left untreated for too long, necrosis of the glans penis can occur. Partial amputation of the distal penis has been reported. The image below depicts severe paraphimosis.
Severe form of paraphimosis. The distal penis has begun the process of autoamputation.
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Media Gallery
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Illustration of paraphimosis. The foreskin is swollen and edematous. A constricting collar or band is present behind the glans penis.
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Mild-to-moderate form of paraphimosis. The treatment involves manual reduction, puncture technique, or medical therapy.
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Severe form of paraphimosis. The distal penis has begun the process of autoamputation.
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This demonstrates the technique of manually reducing the paraphimotic foreskin.
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The puncture method to relieve preputial edema resulting from paraphimosis. Using a needle, several punctures are made in the foreskin to relieve the trapped fluid.
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