Phimosis and Paraphimosis

Phimosis is a condition in which the foreskin gets too tight to be pulled back over the head or glans of the penis.

It occurs in males who have not undergone circumcision (removal of the foreskin covering the tip of the penis). Phimosis resolves or improves on its own with age.

Paraphimosis is a more severe condition affecting the foreskin, in which repositioning of the foreskin to the unretracted position is not possible, and this limits the blood flow to the penis and thus causes a lot of pain and discomfort. Since it affects blood supply it is more often a medical emergency.

In adults, there are certain factors that may lead to Phimosis or Paraphimosis such as-

  1. Repeated urinary tract infections.
  2. Foreskin infection
  3. Repeated rough handling of the foreskin
  4. Sexually Transmitted Infections
  5. Certain other health conditions such as Diabetes (which predisposes one Eczema, Psoriasis, Lichen planus, Lichen sclerosis

Certain symptoms such as those below should hint on Phimosis or Paraphimosis- 

  1. Inability to pull back the foreskin*
  2. Redness, soreness, or swelling of the foreskin
  3. A tight foreskin which may interfere with the normal passage of urine and cause incomplete emptying of the bladder.
  4. Bulging of the foreskin (especially during urination)
  5. Phimosis can lead to inflammation of the penis, called balanitis, or inflammation of both the glans and the foreskin.
  6. Difficulty ejaculating
  7. Difficulty urinating
  8. Discoloration or bruising of the tip of the penis *
  9. Swelling of the tip of the penis *

The diagnosis of phimosis or paraphimosis is made by history and physical examination. Due to the sensitivity of the situation many men feel shy to discuss it with medical practitioners. However, it is very important to talk about it especially if you have any of the symptoms that have been marked with * as they may turn into an emergency.

The treatment most often depends on the cause.

Phimosis is a relatively non- emergency situation and a visit to a urologist can help. The treatment advise is based on the severity of the condition and if it has been recurring. Certain tips on hygiene and treatment for the underlying cause is given if it is non-recurrent. However, if it is serious and recurrent, the doctor may advise you for circumcision.

Paraphimosis, on the other hand, if often an emergency and painful situation which may require minor surgery.

Tips to prevent Phimosis and paraphimosis

  1. Good hygiene – Gently cleaning the penis and under the foreskin, with warm water, every day will help avoid problems. This will help in keeping the skin loose and avoiding infection.
  2. Carefully replacing the foreskin – It is important to replace the foreskin every time it is pulled back.
  3. Being sexually responsible – It is important to use condoms and practice safe sex.
  4. Take care of underlying health issues – that may give rise to either- If you are a diabetic or suffer from any condition that may give rise to recurrent urinary tract infection then it is advisable to keep a check on your underlying condition.
  5. Circumcision – Recurrent Phimosis can be prevented by circumcision.


Written by Dr.Afroze Fatima

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