Article Sections

Introduction

Paraphimosis ( Figure 1) is a urologic emergency that occurs in uncircumcised males when the retracted prepuce (foreskin) is trapped behind the glans.  This causes constriction around the distal penis, limiting venous and lymphatic outflow.  It presents with edema and tenderness of the glans and prepuce.  Without urgent manual reduction, paraphimosis can result in strangulation, vascular compromise, and necrosis of the penile tissue.

Pathophysiology

Prolonged or forced retraction can lead to entrapment of the prepuce behind the rim of the glans (the coronal sulcus).  Constriction around the distal penis limits venous and lymphatic drainage, causing edema and venous congestion of the glans.  Penile arterial flow may then be compromised; if untreated, lack of perfusion can result in ischemia and necrosis of the tissue.

Risk factors

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Figures

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Figure 1
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Figure 2

Tables

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