Phimosis and paraphimosis

Overview

Phimosis refers to the severe narrowing of the foreskin of the penis, so that it can’t be (fully) pulled back over the head of the penis (glans). Painful erections and difficulty urinating are typical. Paraphimosis occurs when the retracted foreskin can't be returned to its original position over the head of the penis, and this causes constriction of the glans.

Symptoms

Phimosis

With phimosis, the foreskin can't be pulled back over the head of the penis. Often there are no symptoms, but possible symptoms include:

• Chronic infection of the foreskin and glans, with swelling and redness
• Foreskin tears, leading to scar tissue
• Problems when urinating and urinary retention
• Painful when touched, pain during erection and intercourse

Paraphimosis

Paraphimosis is the opposite: the retracted foreskin can't be returned to its original position over the head of the penis. Possible consequences include:

• Painful swelling of the constricted glans, which turns blue due to a lack of blood flow
• Urination is impossible (urinary retention)
• In extreme cases, a lack of blood flow to the penis can cause the tip to die off

Causes and treatment

Causes

Phimosis

• Congenital (normal after birth)
• Recurrent infections, inflammation or injury to the glans
• Age-related shrinkage and loss of elasticity

Paraphimosis

• Foreskin of a phimosis patient is pulled back (e.g. during intercourse)
• Infection

Further treatment by your doctor / in hospital

Possible tests

• Careful examination of the tight foreskin
• Swab (for suspected bacterial infection)

Possible therapies

• Phimosis without symptoms: cortisone cream as a temporary measure
• Recurrent foreskin infections or problems when urinating: operation (circumcision, removal of foreskin)
• Paraphimosis is a medical emergency: an incision is made to relieve the tension
  

What can I do myself?

• Under the supervision of a doctor, try to stretch the foreskin over a period of months
• Good personal hygiene reduces the risk of a glans infection

When to see a doctor?

• Recurring glans infections
• Problems when urinating
• Phimosis remains after puberty
• Every case of paraphimosis

Synonyms

phimosis, paraphimosis, tight foreskin, Phimosis and paraphimosis