Definition
Paraphimosis is a condition in which the narrowed foreskin of the penis is pushed back and the glans of the penis is pinched or strangulated. This causes the glans and the retracted foreskin to swell painfully. Often the paraphimosis is caused by a phimosis, a constricted foreskin. A paraphimosis is a urological emergency and requires quick medical and professional help, otherwise the glans threatens to die.
Symptoms of paraphimosis
The paraphimosis was formerly known as the Spanish collar because its appearance is reminiscent of a wide ruff worn by Spanish nobles in the 15th century. This Spanish collar is formed when a foreskin constriction (phimosis) is pre-existing and the foreskin is pulled back from the glans and not brought back to its original position. Then the too tight foreskin forms a lacing ring behind the glans around the penis shaft.
In the following, this lacing prevents the outflow of blood from the glans and the foreskin, resulting in swelling of both the foreskin and the glans. Now the vicious circle closes, because now the foreskin can only be pushed back over the glans with difficulty. However, this situation has to be remedied quickly, because otherwise not enough fresh blood (arterial blood) to supply the penis and glans can enter the glans and the glans dies (necrosis, gangrene).
The retracted glans hinders the outflow of blood from the glans. This results in a very painful swelling of the foreskin and glans, because the tissue fluid (colloquial: water retention) collects there and cannot be removed. Inflammation of the glans, glans reddened, glans burns.
If the paraphimosis persists longer, the supply of arterial blood, in which nutrients and oxygen are transported, also dries up. The foreskin and glans then turn a bluish-black color and are in acute danger. In summary, the symptoms are mainly swelling, pain and in late stages discoloration.
Causes of paraphimosis
Often paraphimosis develops when a tight foreskin, which was pushed back as part of hygienic measures, is forgotten to slip back over the glans. However, it can also happen through medical manipulation, in which the reduction of the foreskin after the insertion of a permanent bladder catheter has been forgotten. In children, paraphimosis may be caused when a manual attempt is made to lift a phimosis (narrowing of the foreskin), which may not actually be present. After sexual maturity, paraphimosis can also be caused by masturbation or during or after sexual intercourse. In connection with sexual activity, paraphimosis is also possible in people who do not show signs of a narrowed foreskin in the non-erect state, but whose foreskin narrowing is based on the fact that the penis increases in size during erection.
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