An About.com Men’s Health article lists phimosis as any condition where the penis foreskin cannot be retracted (pulled back) to reveal the glans (head of the penis). Children's Hospital Boston says this is normal in newborns and over time. The skin on the penile tip can be retracted as the foreskin loosens.
Paraphimosis occurs when the foreskin, once retracted, cannot return to its original location according to WebMD. It’s a medical emergency that can cause serious complications if not treated. Children's Hospital Boston says it can cause entrapment of the penis and impair blood drainage.
About.com states phimosis can be caused by failure of foreskin to loosen during growth. WedMD adds it can be due to an infection, or scar tissue from an injury or chronic inflammation. Another cause of phimosis is balanitis, which leads to scarring and tightness of the foreskin.
Children's Hospital Boston warns phimosis can also occur if the foreskin is forced back before its ready. This can cause a fibrous scar to form, which may prevent future retraction of the foreskin.
WebMD says paraphimosis can occur after an erection or sexual activity or an injury to the glans.
Both Children's Hospital Boston and Lucile Packard Children’s Hospital (LPCH) list phimosis symptoms as bulging of the foreskin during urination and the inability to completely retract the foreskin by age three (in some boys this may take longer).
Paraphimosis symptoms include swelling of the penile tip as the foreskin is retracted; pain; inability to pull the foreskin back over the penile tip; and either dark red or blue discoloration of the penile tip.
Children's Hospital Boston and LPCH say treatment for phimosis may involve applying steroid cream to loosen the foreskin. WedMD adds treatment may include gentle, manual stretching of the foreskin over a period of time.
Beyond this, medical opinion differs. About.com says it’s been suggested any radical or surgical treatments for phimosis should wait until after puberty. Circumcision, the surgical removal of the foreskin, often is used to treat phimosis. Many believe this treatment is overused.
Still Children's Hospital Boston and LPCH say if there is ballooning of the foreskin during urination, after the age of ten, circumcision may be recommended.
WebMD lists another surgical treatment, called preputioplasty. This involves separating the foreskin from the glans. This preserves the foreskin and is less traumatic than circumcision.
Failure to seek treatment for paraphimosis can result in permanent damage to the penis.Treatment of says WebMD focuses on reducing the swelling of the glans and foreskin. If ice and pressure doesn’t work, medication may be injected to help drain the penis. LPCH says in severe cases, a surgeon may make small cuts in the foreskin to release fluid.
Sources:
Phimosis and Paraphimosis: When the foreskin won't retract. About.com by the New York Times Company. Web 23 Oct 2011.
http://menshealth.about.com/cs/embarrassments/a/phimosis.htm
Phimosis and Paraphimosis. Lpch.org by Lucile Packard Children’s Hospital. Web 23 Oct 2011.
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/pandp.html
Phimosis and Paraphimosis. ChildrensHospital.org by Children's Hospital Boston. Web 23 Oct 2011.
http://www.childrenshospital.org/az/Site1447/mainpageS1447P0.html
Penis Disorders. Webmd.com by WebMD, LLC. Web 23 Oct 2011.
http://www.webmd.com/sexual-conditions/guide/sexual-health-male-reproductive-problems-penis-disorders?page=3
Reviewed October 27, 2011
by Michele Blacksberg RN