Symptoms of paraphimosis and basic approaches to treating the disease

Phimosis is a severe narrowing of the foreskin and it is not possible to expose the head of the penis.

The disease phimosis is the precursor of paraphimosis. It can be either acquired or congenital. If the genital organs develop normally, then physiological phimosis disappears over time.

By about 13-14 years old, the head of the boy's penis should open freely. If this is not observed, then physiological phimosis becomes pathological.

Phimosis - a problem that occurs when you try to “expose” the head of the penis. Paraphimosis – there is no way to “close” it.

Paraphimosis in men: causes

For the time being, complications with phimosis (paraphimosis) may not arise. Forced removal of the head of the penis from the narrowed and inactive foreskin is the main cause of paraphimosis. It can be provoked by masturbation (masturbation), sexual intercourse, hygienic procedures, when force is necessary to retract the foreskin.

• Phimosis can occur for several reasons:
• – various scars after injuries;
• – as a result of burns;
• – for skin diseases;
• – with the development of diabetes mellitus;

As a rule, paraphimosis in men is stage 2 or 3 of phimosis, unless there is any treatment. Paraphimosis is the last stage of this disease.

In addition, paraphimosis in men, young men and boys can develop as an independent disease. Quite often the disease occurs as a result of masturbation during adolescence.

It is not uncommon for paraphimosis to appear in adult men.

Paraphimosis in men: causes:

– Features of anatomy. For example, this may occur due to excess foreskin;

- Venereal disease. The penis contains microflora that can become infected. The elasticity of the foreskin decreases. Swelling of the organ may occur and the tissue becomes fixed;

– Chronic kidney disease. As a result of fluid retention, swelling appears in the body.

1. – Sexual intercourse;
2. - Piercing. Getting infected;
3. – For diseases of the cardiovascular system;
4. – Bladder catheterization, cystoscopy.

Paraphimosis in young men and boys

Paraphimosis occurs in both adult men and children. In childhood, boys are more susceptible to this disease. Infringement can occur during masturbation, during hygienic procedures. In addition, paraphimosis in a child can occur during bathing, when the parent tries to forcefully expose the head and wash the penis.

You should know that the head of the penis should be freely exposed and closed by about 2 or 3 years. Before this age, paraphimosis in a child can be physiological. In preschool age, if problems with the foreskin are observed, then this is already considered a pathology. You need to know that paraphimosis in children is operated on under general anesthesia.

Symptoms of paraphimosis

Symptoms of paraphimosis in men are usually severe. It is almost impossible not to notice the development of paraphimosis.

The main symptoms of paraphimosis:

• Pain when touching the penis;
• Severe swelling of the foreskin and glans penis;
• When urinating, urinary retention occurs.

If the above symptoms appear, it is necessary to consult a specialist doctor as soon as possible. If the disease is not treated in time, the advanced stage of paraphimosis will begin.

Symptoms of advanced paraphimosis:

• – Spots appear on the penis. Tissue death occurs;
• – Affected parts may lose sensation;
• – There is no pain. This means that the death of nerve endings occurs;
• – A crust forms on the penis;
• – Darkening of some parts of the genital organ occurs;
• – There is an unpleasant odor coming from the penis;
• – Gangrene may form in the final stages of paraphimosis.
• – In the last stages of the disease, self-amputation of individual parts of the penis occurs.
• Possible complications of paraphimosis in men

If you refuse treatment for paraphimosis, this can lead to quite serious consequences.

Seeing the first symptoms of paraphimosis, you should urgently consult a doctor. The narrowing of the foreskin of the head of the penis with paraphimosis will be much more serious than with phimosis. The blood circulation of the genital organ is very quickly disrupted and tissues may begin to fester.

In addition, the narrowing of the flesh affects the urethra, gradually blocking it. Going to the toilet becomes painful until the man loses the ability to relieve himself. In such a situation, there may be a risk of bladder rupture. It may not come to this, since gangrene will develop faster and ultimately the organ will have to be amputated.

Treatment of paraphimosis in men

How to treat paraphimosis in men? Effective therapeutic methods for paraphimosis should be started immediately after identifying any signs of pathology in a man. A quick visit to a specialist will somewhat slow down the strong swelling of the head of the penis and thereby facilitate the procedure of removal from the preputial ring.

If there are obvious symptoms of paraphimosis, then first of all, even before visiting a doctor, you need to use local cooling. A cold compress or ice bag will do. Some doctors recommend applying a tight bandage to the penis to prevent excessive swelling. This is necessary if there is a sudden pinching of the head of the penis.

After diagnosis, treatment of paraphimosis in men is carried out with medication (conservative) or surgical treatment of the disease.

Paraphimosis in children is treated by a pediatric surgeon. If an adult man experiences a pathological condition, he should consult a urologist, andrologist or surgeon. The diagnosis can be made after a visual examination.

If the cause of paraphimosis has not been established, the doctor will take a smear for analysis. Subsequent examination results will not affect the subsequent regimen and methods of treating paraphimosis.

The disease paraphimosis has ICD 10 code No. 47. This is how the disease is registered in the international medical directory. If a man exhibits dangerous symptoms, it is necessary to call an ambulance as quickly as possible.  

1. The medical team can provide assistance with paraphimosis such as:
2. – Application of a hypertonic solution;
3. – Use of painkillers;
4. – Application of a compressive elastic bandage;
5. – Applying a cold compress to the pinched area.

Subsequent treatment of paraphimosis in adults and children is determined by a specialist doctor. If the pathology is detected in the initial stages, then a treatment method such as reduction of paraphimosis is used.

The infringement of the head of the penis and the necrotic process are eliminated. When treating paraphimosis in children, general anesthesia is administered.

With this method, the doctor presses with his thumbs on the head and at the same time fixes the pinching ring of the foreskin.

Conservative treatment of paraphimosis

The only medications that are used to restore the normal appearance of the penis are analgesics and antiseptics for external use.

They are used to treat the head of the genital organ to reduce its sensitivity. In addition, the doctor may use petroleum jelly or other lubricant (glycerin, for example). It is applied to the skin of the penis to make it easier to reposition the head under the skin.

If these measures do not bring results, the patient is sent to a surgeon for surgical procedures.

It is important to see a doctor

As soon as the first signs of the disease are detected, a man can try to provide himself with first aid.

To do this, you need to lubricate the head of the penis with any cream and try to push it through. If all else fails, you should immediately go to the doctor.

This must also be done if the problem has been resolved. It is advisable to play it safe and consult with a specialist.

Author of the material : Demidov A.S.

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Source: https://lechenie-tut.ru/razdel-muzhskie-zabolevanija/parafimoz-u-muzhchin-lechenie/

A dangerous disease or what is paraphimosis in men? Difference between the disease and phimosis: causes and symptoms of disease

Paraphimosis affects only men and most often they are not aware of what the disease can lead to.

And this is a rather dangerous disease, as it can lead to impotence and even amputation of the genital organ. Paraphimosis often occurs in boys, but adult men are not immune from it.

From this article you will learn that this is phimosis and paraphimosis in men; photos of the disease are also presented here.

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What is paraphimosis in men?

Paraphimosis - what is it? Paraphimosis is a disease in which the head is pinched by the foreskin, which leads to poor circulation. The genital organ quickly swells, due to which tissue necrosis can develop. Ulcers and inflammations form on damaged areas of the penis.

The disease paraphimosis, what causes it? The foreskin narrows so much that it no longer hides the head. At first, you can fix this yourself, but it is better to consult a doctor.

Treatment of the disease by turning to specialists does not lead to positive results. This is not a disease that can be cured only with medications or folk remedies. These methods can only be used in combination.

Now you know what paraphimosis is, photos of the disease are presented below:

What is the difference from phimosis?

What is phimosis and paraphimosis in men, what is the difference between these diseases? It is phimosis that is the main cause of the development of paraphimosis. Unlike paraphimosis, phimosis is a narrowing of the foreskin, which does not make it difficult to expose the head.

This disease occurs for the following reasons:

• diabetes;
• balanoposthitis;
• scars after injuries and burns;
• systemic skin diseases.

Typically, paraphimosis appears at stage 2 or 3 of phimosis in the absence of the necessary treatment. Therefore, paraphimosis is considered the last stage of this disease.

But it can occur as an independent disease. Most often this occurs in childhood or adolescence as a consequence of masturbation, but sometimes paraphimosis occurs in adult men.

The causes of paraphimosis in adults are as follows:

1. Anatomical feature. This could be, for example, excess foreskin.
2. Venereal diseases. The microflora of the penis becomes infected, as a result of which the elasticity of the foreskin decreases. Some diseases can cause swelling of the organ, which causes the tissue to become fixed.
3. Chronic kidney diseases. Edema may appear due to fluid retention in the body.
4. Piercing. The cause of paraphimosis in this case is infection.
5. Sexual intercourse.

Phimosis and paraphimosis are distinguished by the possibility of exposure of the glans penis.

Symptoms

The main symptoms of paraphimosis:

• painful sensations when touching an organ;
• swelling of the head of the penis and foreskin;
• urinary retention when urinating.

These are the first signs of the disease, upon detection of which you need to consult a doctor. If this is not done, an advanced stage of paraphimosis begins with the following signs:

• spots appear on the genital organ, indicating the process of tissue necrosis;
• the affected parts lose sensation;
• there are no painful sensations, which indicates the death of nerve endings;
• a crust may form on the genitals;
• some parts of the penis darken and become black;
• an unpleasant odor emanates from the genitals;
• in the last stages of the disease, gangrene may form;
• at the end, self-amputation of individual parts of the organ occurs.

REFERENCE: the last stage is very rare and occurs in the most advanced cases, but this does not mean that it is necessary to delay treatment.

Refusal to treat paraphimosis often leads to dire consequences. Already the first symptoms should force a man to go to a specialist.

Since the narrowing of the foreskin with paraphimosis is much more serious than with phimosis, the blood circulation of the organ is disrupted very quickly. The tissues begin to die and rot occurs.

The narrowing also directly affects the urethra, gradually blocking it. Going to the toilet becomes more and more painful until the man loses the ability to relieve himself.

And this threatens to rupture the bladder. But most often it does not come to this, since gangrene develops much faster. And as a result, the genital organ will have to be amputated.

Why is it important to see a doctor?

As soon as the first signs of the disease are detected, the man can try to provide first aid to himself. To do this, you need to lubricate the head of the penis with any cream and try to push it through.

If all else fails, you should immediately go to the doctor. This must also be done if the problem has been resolved. It is better to play it safe and consult a specialist.

If you have symptoms, you can contact a urologist, surgeon or andorologist. The patient is admitted to the hospital, where the specialist quickly carries out the following actions:

1. Cutting the foreskin and applying sutures.
2. In particularly difficult cases - complete or partial amputation of the organ.

The procedure is carried out under local anesthesia, that is, the genital organ is lubricated with an anesthetic. If it is necessary to perform a full-fledged operation, general anesthesia is used.

After surgery, the patient is prescribed antibiotics and rinsing the penis with antiseptic agents.

Treatment of paraphimosis, as well as treatment of phimosis in later stages, is carried out only with the help of surgery. Conservative treatment is used only at the initial stage, when the first signs of the disease appear. Read about the use of corticosteroid ointments against phimosis in men in this article.

To prevent the disease, doctors recommend that men pay as much attention as possible to personal hygiene and also use protection during sexual intercourse.

To avoid provoking a relapse, you should lead a healthy lifestyle and undergo an annual examination. A guarantee that the disease will not return is provided by the procedure of circumcision of the foreskin.

The sooner signs of the disease are identified and diagnosed, the better for men’s health.

In the initial stages, when the head was set manually, the disease may reappear. Therefore, it is better to undergo a surgical operation, which will protect against relapse in the future.

Source: https://samec.guru/zabolevaniya/andrologiya/fimoz/parafimoz-simptomi-i-priznaki.html

Paraphimosis: diagnosis, symptoms, treatment

Paraphimosis in men is a condition that requires emergency medical attention and is a pinching of the head of the penis by the foreskin.

Representatives of the stronger sex suffering from it often try to correct the situation on their own, but if they fail, they may experience necrosis of the glans penis.

Paraphimosis is a complication of phimosis , a condition in which a man experiences a narrowing of the foreskin (prepuce) of the genital organ. In this case, it becomes impossible to move the skin fold behind the head of the penis without causing discomfort and pain.

Paraphimosis is one of the complications of this condition, in which the ring of the foreskin turns out to be so narrow that when it is forcibly inserted behind the head of the penis, it pinches it and prevents normal blood flow.

Basic information 

Prevalence

Paraphimosis is not a common disease, and is diagnosed in less than 5% of men diagnosed with atrophic phimosis or other varieties of this disease. 

Risk factors

The risk group includes only those men who have a narrowing of the prepuce.

Causes and consequences of paraphimosis

Since paraphimosis is a consequence of phimosis, the causes of the pathology should be sought in phenomena that provoke a narrowing of the foreskin. This can happen both in childhood and in adulthood.

In the first case, the prepuce narrows due to too early forced exposure of the head of the genital organ or masturbation, in the second - various diseases and conditions:

• injury to the foreskin due to inaccurate friction during sexual intercourse;
• systemic pathologies of a dermatological nature, affecting the elasticity of the skin and the frenulum of the foreskin in particular;
• incorrectly performed catheterization or cytoscopy procedure;
• primary syphilis or other sexually transmitted infections, as a result of which scars may form on the foreskin;
• burns and injuries to the genital organ, after which scars appeared on the foreskin;
• unsuccessful intimate piercing.

Diseases such as diabetes mellitus can also negatively affect the foreskin ring . Cases have been recorded where pathological narrowing of the foreskin led to paraphimosis.

It is impossible to call this pathology insignificant or not playing a role in the general condition of a man. Even if the narrowed prepuce is in a normal anatomical position, it can significantly worsen the life of a sick man, making it difficult to urinate. In addition, the lack of normal hygiene of the head of the penis can systematically result in an inflammatory process.

The most dangerous complication of paraphimosis in men is necrosis of the tissues of the genital organ, more precisely its head.

In this case, tissue death can be total or localized. In the first case, the head of the penis dies completely due to insufficient blood flow, and in the second, non-healing ulcers form on it, through which infections easily enter the body.

Video: “Paraphimosis - what is it”

Paraphimosis symptoms and diagnosis

The onset of a pathological process called paraphimosis is almost impossible to miss.

The symptoms are always acute and consist of the following clinical manifestations:

• the genital organ swells, with the head especially increasing in size;
• the head of the penis acquires a bluish tint;
• it is difficult for a man to move due to significant pain in the genital organ; the pain also worsens when urinating.

When paraphimosis appears, a man tries to spread his legs wider and tilt his body forward. However, such tricks do not lead to relief. If you do not start treatment for the pathology in the first 30-40 minutes after the head is pinched by the ring of the foreskin, its necrosis may occur. This condition is expressed by darkening of the head of the penis, even blackening.

Diagnosing paraphimosis is not difficult due to its obvious symptoms. In most cases, an external examination of the patient and anamnesis are sufficient to make a correct diagnosis. During the conversation, the doctor determines the time of development of the pathology. Based on this, the specialist makes a decision on methods of treating the disease.

Treatment of paraphimosis

Therapeutic measures for paraphimosis must begin immediately after the man shows signs of pathology. This will slow down excessive swelling of the head of the penis, and thereby facilitate the procedure for removing it from the preputial ring.

The first thing to do before visiting a doctor is to apply local cooling. You can use an ice pack or a cold compress. Some experts advise that in case of sudden pinching of the head of the penis by the foreskin, apply a tight bandage to the penis to prevent excessive swelling.

After diagnosis, a man with paraphimosis is prescribed medication (conservative) or surgical treatment.

Conservative elimination of paraphimosis

Drug treatment for paraphimosis is not used due to its ineffectiveness.

• They are used to treat the head of the genital organ to reduce its sensitivity.
• In addition, the doctor may use petroleum jelly or other lubricant (glycerin, for example).
• It is applied to the skin of the penis to make it easier to reposition the head under the skin.
• If these measures do not bring results, the patient is sent to a surgeon for surgical procedures.

Surgical removal of paraphimosis

Surgical treatment of paraphimosis is carried out using two methods:

• When the pathology first occurs, a longitudinal dissection of the preputial ring is performed.
• If the pathology reoccurs, a circular excision of the foreskin (circumcision) is performed.

Both procedures are performed under local anesthesia (the drugs Lidocaine or Novocaine are used). The surgical intervention lasts no more than 15 minutes. After the procedure, the man is given stitches and a sterile antibacterial dressing.

Recovery after surgical treatment of paraphimosis lasts at least 4 weeks. During this time, the man is advised to abstain from sexual intercourse and also maintain careful intimate hygiene. Antibiotics are also prescribed in the form of ointments, and in case of extensive excision of the foreskin - in the form of tablets.

Video: “Treatment of paraphimosis”

Treatment of paraphimosis at home

It makes sense to treat paraphimosis at home only if no more than five minutes have passed since the head of the penis was pinched. If it was not possible to insert the head back under the skin within this period of time, you should consult a doctor.

However, after surgery or manual reduction, folk remedies with anti-inflammatory and antimicrobial properties can be used.

Home therapy uses:

• a decoction of chamomile or yarrow in the form of lotions and compresses;
• calendula decoction for compresses and sitz baths;
• St. John's wort in the form of a decoction;
• oil infusion of propolis;
• sea ​​buckthorn oil.

It makes sense to use folk remedies only when the pinching of the head of the penis is eliminated!

Prevention of paraphimosis

To eliminate or minimize the likelihood of paraphimosis, you must follow simple rules:

• eliminate any infections of the genitourinary system in a timely manner;
• treat chronic skin diseases;
• try not to injure the penis with phimosis, even to a mild degree;
• do not have sex while intoxicated if you have diagnosed phimosis (this is what most often causes the onset of paraphimosis).

In addition, to prevent paraphimosis, it is recommended to undergo regular examination by a urologist. For healthy men, this can be done once a year, but for those diagnosed with diabetes, examinations should be carried out more often - 3 or 4 times a year.

Forecast

Paraphimosis is not a deadly disease ; however, when it occurs, a man risks undergoing penile amputation.

According to experts, if assistance is not provided within 30-40 minutes after the onset of pinching, the likelihood of irreversible tissue necrosis increases to 85%.

If a man consults doctors within 3-15 minutes, the prognosis is very favorable.

Conclusion

Paraphimosis is a fairly rare diagnosis, it is observed in less than 5% of men with phimosis. Since this disease can lead to the death of the flesh of the penis, when it is diagnosed, you must immediately contact specialists for medical help. Paraphimosis is mainly treated with surgery.

Source: https://kakbyk.com/bolezni/khirurgicheskie-zabolevaniya/parafimoz-diagnostika-simptomy-lechenie.html

Paraphimosis symptoms treatment consequences

Paraphimosis is a narrowing of the foreskin of the penis

What is paraphimosis and what complications can there be?

Paraphimosis is a complicated stage of phimosis (narrowing of the foreskin of the penis) with pinching and compression of the penis.

A dense ring of foreskin forms around the head, which prevents its movement along the penis and causes a pathological condition to the male penis.

The disease develops with existing physiological phimosis, with which men can live their whole lives, but paraphimosis is fraught with swelling and cyanosis of the head, impaired blood circulation in the organ and complete atrophy of the genital organ.

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Possible consequences of the disease

Paraphimosis is always accompanied by pain in the glans penis

Self-reduction of the head of the penis is possible if there are no aggravating circumstances of the pathology:

1. infectious and inflammatory diseases inside and outside the penis;
2. not primary pinching of the head, when swelling begins to develop quickly;
3. the last stages of phimosis, in which the foreskin is strongly fused with the connective tissue and its movement onto the head is impossible;
4. damage to the penis - ulcers, wounds;
5. serious condition of the patient with necrosis of organ tissue.

Paraphimosis always causes pain in the area of ​​the glans penis. But there may also be a subsidence of the painful symptom and an increase in the foreskin ring. This is a bad sign. Gradual necrosis of the tissues of the head will lead to surgery to remove the genital organ.

If you consult a doctor immediately if the head is pinched, you will be able to avoid amputation of the penis and restore the natural functions of the reproductive organ.

How to avoid and prevent the occurrence of pathology

The primary cause of paraphimosis is congenital phimosis. The pathology has different stages, but if the disease is not treated, it will sooner or later lead to paraphimosis. If a boy is diagnosed with phimosis, it is necessary to eliminate the pathology as soon as possible. Men with problems with the movement of the foreskin should see a urologist or surgeon to avoid serious consequences.

Another important factor in preventing paraphimosis is the correct implementation of hygiene procedures, when too much stretching of the foreskin or forced opening of the head can cause pinching of the head and make it difficult to set it back. Injury to the penis and diseases on the skin of the organ must be eliminated so that tissue inflammation and necrosis of epithelial cells do not occur.

Source: http://AptekaMan.ru/blog/parafimoz-simptomy-lechenie-posledstviya.html

Paraphimosis

Paraphimosis is an acutely developed condition in which the narrowed foreskin impinges on the head of the penis and cannot spontaneously return to its normal position. Paraphimosis is characterized by severe pain in the area of ​​pinching, an increase in volume and cyanosis of the head of the penis, swelling of the foreskin, which looks like a dense swollen cushion, and difficulty urinating. The diagnosis of paraphimosis is based on the results of an external examination of the penis and anamnestic data. Treatment of paraphimosis may include conservative bimanual reduction of the strangulated glans penis and surgical methods - puncture of edematous tissue, longitudinal dissection of the foreskin (incision), circular excision of the foreskin (circumcision).

N47 Excessive foreskin, phimosis and paraphimosis

Paraphimosis is a complication of phimosis that develops when the exposed glans penis is pinched at its base by a dense narrow ring of preputial tissue. Paraphimosis occurs when the foreskin is completely retracted (retracted) beyond the coronary sulcus. With paraphimosis, spontaneous retraction of the head of the penis into the preputial sac becomes impossible.

The main danger of paraphimosis is the likelihood of necrosis and gangrene of the glans penis, therefore in andrology and urology this condition is regarded as requiring emergency medical care. Most often, paraphimosis develops in boys and young men, but can also be diagnosed in adult men.

Paraphimosis

Paraphimosis is a complication of congenital or acquired phimosis. Normally, the separation of the outer and inner layers of the foreskin occurs independently, starting at birth and ending during puberty. In the first years of a boy’s life, “physiological phimosis” is observed, caused by epithelial gluing of the glans penis and the inner layer of the foreskin.

Spontaneous opening of the preputial sac in most cases occurs between the ages of 3 and 6-7 years.

Intensive premature retraction of the foreskin with the removal of the head of the penis becomes the cause of most cases of true phimosis.

Paraphimosis occurs in the presence of grade II–III phimosis, rarely develops in grade I, and does not occur in grade IV phimosis, when it is impossible to expose the head of the penis.

In boys, paraphimosis most often occurs during hygiene procedures due to forced attempts by parents to push the skin beyond the coronary sulcus.

In adult patients, pinching of the glans penis by the narrowed foreskin can develop during masturbation or sexual intercourse.

Iatrogenic paraphimosis can occur as a result of forced exposure of the glans penis during catheterization of the urethra and bladder, or cystoscopy.

It is possible to develop paraphimosis with primary syphilis and the presence of a syphilitic prepuce ulcer; with the development of allergic reactions from the genitals.

Cases of paraphimosis occurring during penile piercing have been described.

Paraphimosis occurs as a result of forced retraction of the narrowed foreskin at the base of the glans penis and the inability to return it back. Circular infringement of the glans penis by the foreskin leads to venous and lymphatic stagnation, rapid development of tissue edema and disruption of arterial blood flow.

Paraphimosis has an acute onset and manifests itself with pronounced local symptoms. With paraphimosis, the foreskin takes on the appearance of a dense, swollen cushion under the head of the penis. Infringement contributes to an increase in edema and a significant increase in the volume of the head of the penis, which is accompanied by increased compression of it by a ring of preputial tissue.

The proximal part of the shaft of the penis is not changed. With paraphimosis, sharp pain and cyanosis of the glans penis appears; the pain intensifies at the slightest touch. The typical posture of a patient with paraphimosis is legs wide apart and the body bent forward.

With paraphimosis, urination becomes difficult; Children may develop acute urinary retention.

If paraphimosis occurs, you must immediately consult a doctor: a pediatric surgeon, urologist or andrologist. The diagnosis of paraphimosis is established on the basis of anamnestic data and visual examination of the penis.

First aid

Paraphimosis is an emergency condition requiring urgent medical intervention.

First aid for paraphimosis consists of applying cold (ice pack, cold compress) to the pinched area; applying a bandage with a hypertonic solution, an elastic compression bandage; carrying out applications of local anesthetics, injections of hyaluronidase into the area of ​​edema. These measures not only reduce pain, but also reduce swelling of the glans penis.

Conservative therapy

Treatment of paraphimosis can be conservative and surgical.

If paraphimosis is detected in a timely manner, conservative bimanual reduction of the glans penis into the pinching ring of the foreskin is performed under local (in children - general) anesthesia after lubricating the surface of the penis with petroleum jelly or glycerin.

Sometimes a puncture of the edematous tissue of the foreskin is performed first to create an outflow of fluid. After successful reduction of paraphimosis, local baths with a solution of potassium permanganate, applications of camphor oil, and prednisolone ointment are prescribed.

Surgery

If 2-3 attempts to reduce the glans penis are unsuccessful, a preliminary longitudinal (dorsal) dissection of the pinching ring is performed.

Since paraphimosis is accompanied by deformation of the foreskin, in order to avoid repeated cases of strangulation, 1-1.5 months after the acute process subsides, a circular excision of the foreskin (circumcision) is performed.

Nowadays, circumcision is often performed using a laser or radiosurgical scalpel. To prevent postoperative infectious complications, antibiotics and restorative therapy are prescribed.

With timely consultation with a doctor and surgical treatment of paraphimosis, the prognosis of the disease is favorable. Advanced cases of paraphimosis threaten necrosis and ischemic gangrene of the glans penis, requiring amputation.

Prevention of paraphimosis consists of early diagnosis and treatment of phimosis, prohibition of premature forced retraction of the foreskin, and careful conduct of urological manipulations.

To identify phimosis, teenage boys must be examined by a pediatric urologist-andrologist.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_andrology/paraphimosis

Paraphimosis

Content

1. Causes and symptoms
2. Treatment

Paraphimosis is an acute pathological condition in men in which a narrowing of the foreskin on the penis occurs. It pinches the head, which cannot return to its normal position on its own.

This disease leads to blockage of blood vessels, as a result of which the blood supply to the organ is disrupted and the head swells.

At the same time, the man experiences severe pain, the head gradually changes in color - it appears bluish, and urination becomes difficult.

Reasons for the development of pathology

The main cause of paraphimosis is phimosis, a condition in which the ring of preputial tissue of the male organ narrows. Paraphimosis is a pathology that follows phimosis, when the head is pinched and exposed for a long time.

Boys have physiological phimosis from birth. It does not pose a threat to the health of babies, since the cause of this condition is the gluing of the epithelium above the head of the organ and the inner layer of skin.

Normal spontaneous separation of the foreskin and glans occurs from 3 to 7 years. Paraphimosis in boys and young men develops at stages 2 and 3 of phimosis. This is caused by early, constant retraction of the preputial tissue.

The main causes of paraphimosis:

• Phimosis due to balanoposthitis, trauma to the penis, diabetes mellitus, dermatological diseases of the foreskin.
• Carrying out hygienic manipulations with arbitrary removal of the skin beyond the end of the head (coronal sulcus). In infancy, it is necessary to carefully care for the boy’s genital organ, without trying to free the head from the preputial sac.
• Masturbation, sexual intercourse.
• Medical procedures: insertion of a catheter into the bladder or urethra, cystoscopy.
• Diseases such as primary syphilis, an autoimmune reaction localized in the genital area.
• After piercing on the glans penis.
• Short and inelastic frenulum of the foreskin. It does not allow the head of the penis to return to its original position after it is exposed.

Manifestation of the disease

Symptoms can be determined visually and by the patient’s sensations. With the development of paraphimosis, the head of the male organ turns blue, swells, and edemas.

Due to constant compression of the head, blood gradually stagnates in the venous vessels and lymph, and arterial blood flow is disrupted.

The acute course of the disease can be seen even by a non-specialist, since a cushion appears around the head of the penis, which gradually swells, and the swelling increases. At the same time, the head increases in volume.

The pain is strong and occurs at the slightest contact with the head of the penis.

Based on the appearance of the patient, one can also draw a conclusion about his condition: it is typical for these symptoms to sit with legs wide apart and the torso bent slightly forward. Children are diagnosed with acute urinary retention.

If treatment is not started in time, the tissues of the head will begin to die, and the patient will have complications in the form of ischemia and local necrosis of the tissues of the head. The condition of the tissues of the penis may serve as an indication for removal of part of the head, or auto-amputation of the affected part of the male organ will occur.

Establishing diagnosis

If symptoms occur, you should immediately consult an andrologist or urologist; consultation with a surgeon is often required. During the initial diagnosis, the specialist assesses the position of the head, damage to the tissues of the foreskin, the duration of the swelling and the rate of its increase.

Treatment

With this disease, it is important to provide medical care in a timely manner so that complications do not arise. This requires:

• Apply cold to the swollen area, this can be a cold compress or an object with ice.
• A bandage is applied to the affected area with a hypertonic solution for disinfection, and an elastic bandage is wrapped on top for moderate compression.
• Hyaluronidase is injected into the site of swelling to reduce it;
• To alleviate the patient's condition, applications with anesthetic drugs are applied to the surface of the skin of the penis.

All these actions are considered first aid for paraphimosis. They serve to reduce swelling and relieve pain. With this disease, these manipulations precede the immediate treatment of the ring compressing the head. It can be done conservatively or surgically.

Conservative treatment of paraphimosis

This method is used in the initial stages of paraphimosis. The doctor pushes the head into the ring of the foreskin. The process is sure to relieve pain, especially in children. The surface of the penis is lubricated with Vaseline ointment, baby oil or petroleum jelly. To drain fluid in case of severe swelling, a puncture of the organ is performed.

After reduction, the tissues remain swollen for some time, and the pain does not go away immediately.

Prednisolone ointment made from glucocorticosteroids can be used to resolve and remove swelling and inflammation.

Surgical intervention

To release the head, the compression ring is cut with surgical instruments, or a certain part of the foreskin has to be removed. A bandage is applied to the incision site. If cut, the patient may soon leave the hospital. If the surgeon removed part of the skin above the head, the patient must spend several days in the hospital.

Prevention and prognosis of the disease

In order to prevent the development of paraphimosis, the problem of phimosis should be addressed in a timely manner, since it is this that leads to the development of an acute disease. In some cultures, the best prevention of paraphimosis is circumcision, sometimes forced.

Prevention of paraphimosis is to consult a doctor at the first symptoms of phimosis; there is no need to self-medicate - this is dangerous for the health and preservation of the functionality of the organ.

In childhood, it is impossible to free the head for the sake of hygiene - the time will come, it will free itself. It is also necessary to teach boys that forced retraction of the foreskin leads to illness and pain. Urological manipulations must be careful. A preventive measure is also regular examination by a urologist-andrologist in childhood and adolescence.

The prognosis of the disease is favorable with timely consultation with a specialist and treatment of the disease.

If you do not go to a medical facility at the first symptoms and endure the pain, the disease can quickly develop with subsequent death of tissue on the head of the penis.

Self-medication in this case will not bring the desired results, but, on the contrary, will complicate the situation and worsen the patient’s health.

Causes and symptoms

If a narrowing occurs in the area of ​​the foreskin, which pinches the penis, namely the glans, the disease is called paraphimosis. It is necessary to take into account that it is impossible for the process to return to normal on its own.

With this pathological process, there is a deterioration in the quality of life, a sharp pain syndrome appears, specifically in the area of ​​​​incarceration, and the presence of a bluish coloration of the soft tissues. If paraphimosis is detected, symptoms may bother the patient from the very beginning of the disease. A man also quickly experiences swelling of the head of the penis, problems in his intimate life, and the inability to defecate normally.

The most characteristic element is the presence of a ridge around the head, which clearly proves that the patient has paraphimosis.

As for treatment, there are two methods of helping the patient - conservative and surgical. If treated without surgery, then the usual reduction of the pinched penis is performed bimanually. If conservative treatment is impossible, doctors resort to surgery. This is either an incision made in the foreskin to relieve the infringement, or complete excision - circumcision.

Paraphimosis causes

This disease occurs both from birth in a baby and can occur in an adult. As soon as the external genital organs begin to form in boys, they are formed from two leaves, which are divided into external and internal.

This development ends at the stage of final formation of sexual characteristics. There is such a term as phimosis of a physiological nature. This is normal, but should be monitored dynamically. You can see what paraphimosis looks like in the picture.

Typically, paraphimosis does not occur out of the blue. It appears only when phimosis is observed at an advanced stage, that is, the second or third. In the early stages of phimosis, the appearance of paraphimosis occurs exclusively in rare cases.

Well, accordingly, at the last stage of phimosis, the appearance of paraphimosis is also impossible, due to the virtual absence of exposure of the patient’s head.

Paraphimosis diagnosis

In most boys, this pathological condition appears as a result of hygienic procedures. Parents force the skin apart by tightening the coronal sulcus to rinse thoroughly. As for adults, such infringement can occur as a result of sexual contact with a partner or during masturbation. There are also facts that paraphimosis appears as a result of reduced elasticity of the skin in the area of ​​the external genitalia. The outcome of this phenomenon is that the man’s tissues cannot return to their original position. The color of urine with paraphimosis is normal. Occasionally, color changes occur due to an advanced process when deep necrosis of the penis occurs. The urine begins to become cloudy and reddish in color. There have also been cases when, after piercing, such a pathological manifestation appeared.

Paraphimosis signs

Like many other reproductive diseases, paraphimosis begins abruptly, with a sharp picture of all clinical manifestations. If a diagnosis of paraphimosis is made, the clinic where the treatment will be carried out must quickly decide on tactics to stop the process.

The clinical manifestations of the disease are pronounced, increased swelling, as a result of which the cushion along the foreskin increases. As for the other end of the penis, with this disease everything is calm, only the distal end suffers.

If treatment is not started in time, tissue necrosis may occur, resulting in partial amputation of the penis.

Treatment

As soon as you suspect that you have paraphimosis, you should immediately seek medical help from a doctor. These may be specialists such as a surgeon, urologist. If this is a child, then accordingly to pediatric surgical doctors.

The diagnosis of this pathological process is made by collecting the patient’s medical history, as well as examining the process of inflammation in the distal area of ​​the penis.

Treating paraphimosis at home is strictly prohibited unless recommended by your doctor.

This disease is a condition that should be treated immediately. That is, this illness refers to urgent illnesses. First of all, such a patient needs to apply cold to the distal end of the penis. This could be a compress or a container of cold.

Further, it can be treated by applying a special bandage consisting of a solution of hypertonic origin, an elastic bandage. Some doctors apply applications of local painkillers to relieve pain.

The above first aid methods not only relieve pain, but also significantly relieve swelling in the area of ​​the male genital organ.

There are two treatment plans for paraphimosis in men. This is a conservative and surgical method, despite the fact that the treatment tactics are chosen exclusively by the doctor, based on the severity and neglect of such a process. The most popular non-surgical treatment method is manual reduction of the distal end of the penis. If this fails, then an operation is performed and a cut is made in the pinched area. The ring is excised and the patient quickly recovers and lives a normal life. If within a certain period of time you do not provide any assistance to the patient, or treat it yourself, then tissue necrosis may simply occur, with further necrosis of the organ. Treatment for paraphimosis in children is the same as in adults.

In order to prevent painful processes and swelling in the initial stages of paraphimosis, you must try to straighten the foreskin yourself. For convenience, it is necessary to apply some kind of lubricant of a more liquid nature. In this case, it can be any hand cream, vegetable oil or regular Vaseline.

If, on the contrary, within five minutes you were unable to straighten it, then you should immediately seek help from a doctor. In the absence of timely reduction, it leads to the fact that you can simply lose the distal end of the penis once and for all. Conservative treatment of paraphimosis in boys is also permitted, but parents must do this.

Typically, children do not immediately turn to their fathers and mothers, so most often it is extremely problematic to correct them conservatively.

This is what paraphimosis looks like in boys photo. Treatment of children must be carried out quickly.

Operation for paraphimosis - technique

A surgical method of relieving this disease is performed only when there was no success conservatively, or the treatment was later. Also, an indication for radical treatment is the presence of gangrene or necrosis of the head in the patient.

As soon as the patient seeks help, doctors quickly provide pain relief. If this person is an adult and of full age, then he can be given local anesthesia by injecting a lidocaine solution. The injection is made directly to the site where the head is pinched. As for children, everything is different here. According to all international protocols, children are given general anesthesia.

After the anesthesia has begun to take effect, the doctor also tries in every possible way to straighten the head bimanually. If after several attempts the reduction is unsuccessful, then a radical method should be resorted to. A small incision is made in the area where the pinching occurred.

Next, the patient is prescribed anti-inflammatory drugs, as well as dynamic dressings daily. Most often, drugs are prescribed in the form of gels, which contain elements that can fight inflammation.

Dressings are necessary in order to prevent the development of infection; doctors wash the site of the operation with specialized solutions. The most prominent representative of solutions to combat infection is furatsilin. When such procedures are performed, success with such a diagnosis is extremely positive.

If the patient has an advanced form of paraphimosis, then complete removal of the dead areas of the foreskin is performed. Next, medications are also prescribed to combat inflammation and prevent infection.

Many people are interested in the question of how to treat paraphimosis at home? As mentioned above, if an infringement occurs, then for the first time in minutes, you can straighten it yourself. If the result is negative, it is strictly forbidden to treat yourself. Home treatment for paraphimosis is carried out only in the initial stages of the disease.

If paraphimosis is corrected, the price is set individually for each person, depending on the region of residence and the clinic itself.

The most important element in the tactics of treating this disease is that if certain necrotic areas of tissue are observed, then conservative treatment is strictly prohibited. This condition can only be treated surgically.

After surgery, there have been cases where complications arose. This was either the addition of an infection or the formation of a subcutaneous hematoma. But all these complications are not threatening to the patient, and if the patient is treated correctly, the outcome will be favorable.

From the moment of the operation, the patient fully recovers within 20 days with a favorable course.

Source: https://yrologiia.ru/parafimoz.html