Facts on Foreskin Problems

Two conditions can occur with the foreskin of the penis of an uncircumcised or improperly circumcised boy or man, 1) phimosis and 2) paraphimosis

Phimosis: This condition occurs when the foreskin cannot be retracted (pulled back) behind the head (glans) of the penis. This is called phimosis. It is usually a condition found in children and occasionally adults. Physiological phimosis is the normal condition that occurs mainly during the first year of life when the foreskin is not retractable in these young males. This may occur until about 3 years of age. This condition is not a congenital problem such as buried penis (the penis is located beneath the abdominal skin). Phimosis can often lead to a painful type of infection called balanitis.

Paraphimosis: This condition, paraphimosis, is somewhat the opposite of phimosis. The foreskin, after being pulled back, becomes trapped and then swollen behind the head (glans) of the penis.

The swelling can lead to blockage of blood flow to the penis, which can lead to gangrene of the penile shaft and head distal to the welling.

Paraphiosis is considered a true medical emergency. Circumcision (surgical removal of the foreskin) at birth or revision of a prior circumcision can prevent this condition.

Foreskin Problems Causes

Causes for phimosis include infection, poor hygiene, and previous foreskin injury.

Any condition or activity that results in prolonged foreskin retraction can lead to development of paraphimosis.

  • An improperly circumcised penis
  • Frequent insertion of bladder catheters
  • Vigorous sexual activity, including masturbation
  • Males forgetting to return the foreskin to its normal position after retracting it (for example, an elderly patient who needs self-catheterization)

Foreskin Problems Symptoms

The following is a list of symptoms that males may have if they develop problems with the foreskin that usually appears swollen.

With phimosis, the male child may have any or all of the following signs and symptoms:

  • Difficulty with urination
  • Pain upon urination
  • Blood in the urine
  • Pain in the penis

With paraphimosis, males can have these additional symptoms:

  • Penile pain (particularly in the glans)
  • Penile discoloration (this occurs after blood flow is cut off); penis may become whitish, bluish, gray colored, or black

When to Seek Medical Care fo Foreskin Problems

Phimosis usually does not require emergency medical treatment and many mild occurrences resolve without medical intervention. However, if the person has any urinary symptoms, for example, difficulty urinating or burning upon urination, then a doctor should be contacted within 12-24 hours. In certain circumstances, treating phimosis can lead to paraphimosis, which does require immediate medical attention.

With paraphimosis, if a person cannot return the foreskin to its original position and the glans or foreskin becomes progressively more painful, swollen, or discolored, seek immediate medical attention.

Paraphimosis is a medical emergency. If not treated immediately, it can result in gangrene of the glans and foreskin. Apply ice to the penis to reduce swelling; however, if the ice and direct pressure technique does not relieve the problem rapidly, go immediately to the nearest hospital's Emergency Department or to a doctor' office.

Foreskin Problems Self-Care at Home

At this time, there is no recommended home therapy for phimosis except to practice good hygiene. Keep the groin area clean and dry.

Self-care treatment for paraphimosis includes applying ice to the penis to reduce swelling. One method is to place ice in a rubber glove and then place the penis inside the glove. After cold application, apply pressure to the glans while simultaneously pulling forward on the foreskin. If this does not resolve the problem, then immediately contact a doctor or go to an Emergency Department. If this is a recurrent problem, contact a doctor for an appointment.

Foreskin Problems Prognosis

With either condition, timely treatment usually resolves of the problem. However, if either problem is neglected, the outlook can be poor, with recurrent urinary and kidney infections, gangrene, and even potential loss of the penis (by auto-amputation or dry gangrene.

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