Paraphimosis: Causes, Symptoms, Treatment and Cost

When the foreskin of the penis retracts and does not return to its normal position, this is referred to as paraphimosis. A traumatic retraction, an injury, or an infection can all be the cause of this disease.

This condition can affect males of any age, but most commonly occurs in uncircumcised boys between 1 and 5 years old. There are three types of paraphimosis: acute, subacute, and chronic.

• Acute Paraphimosis: Acute paraphimosis is when the foreskin becomes trapped so quickly that it causes immediate swelling and pain. This type is often caused by an object such as a toy or clothing item having been trapped behind the glans.
• Subacute Paraphimosis: Subacute paraphimosis occurs when the foreskin remains trapped for several days before becoming swollen or painful. It usually results from an infection or irritation that causes swelling at the tip of the penis, trapping the foreskin behind it.
• Chronic Paraphimosis: Chronic paraphimosis occurs when there is no obvious cause for why the foreskin has become stuck behind the glans and remains there for an extended period of time (months to years). In these cases, scarring can occur which may require surgery to correct.

• Paraphimosis is caused by the failure to reduce an erect penis back into its natural position after foreskin retraction.
• This may happen due to inadequate techniques during circumcision, medical procedures, or forceful retraction of the foreskin.
• It can also be caused by an infection, trauma to the penis, or a tight-fitting ring around the penis.

A bulging and retracted foreskin that cannot be drawn back over the head of the penis is the most typical indication of paraphimosis. It is the most obvious manifestation of the disease that a person could experience. Other signs may include pain, swelling, redness, and difficulty urinating.

To prevent paraphimosis, proper hygiene should be maintained in order to reduce chances of infection and inflammation.

It is also important to retract the foreskin and clean underneath it regularly, but gently, to ensure that it does not become too tight or trapped behind the glans.

Additionally, if a person experiences pain or difficulty in retracting their foreskin, they should consult a doctor for further evaluation and treatment.

Diagnosis of paraphimosis typically involves physical examination and possible tests such as urinalysis, ultrasound, or a blood test.

• Physical Examination: The physical examination will involve checking for swelling, discoloration, or any other signs of injury that may have caused the foreskin to become stuck in a retracted position. The doctor may also use an instrument called a proctoscope to look inside the penis and see if the tissue surrounding the foreskin is overly tight or swollen.
• Urinalysis: It can be done to check for infection while blood tests may help identify any underlying medical conditions that could be contributing factors in causing paraphimosis.
• Ultrasound: It can help determine if there is any damage to tissues surrounding the penis that might have caused it.

The most common complication of paraphimosis is necrosis or gangrene of the glans, which can lead to permanent damage, including loss of sensation and erectile dysfunction.Other complications include pain, swelling, infection, and urethral obstruction.

It is important to seek medical attention immediately if paraphimosis is suspected as these complications can have serious implications for a person's health.

• Applying a warm compress to the affected area: To reduce swelling, apply a warm compress to the affected area for 15-20 minutes at least 3-4 times per day.
• Massage and stretching exercises: Gently massage the affected area and perform stretching exercises to gradually reduce the swelling.
• Applying an herbal paste: Make a paste of equal parts of turmeric powder, fenugreek powder, and neem powder with some water or coconut oil.
• Taking Ayurvedic herbs: Consume Ashwagandha (Withania somnifera) and Bala (Sida cordifolia) as per your Ayurvedic practitioner’s advice, which can help reduce inflammation and swelling in paraphimosis.
• Applying ice packs: Wrap some ice cubes in a thin cloth or towel and apply it to the affected area for 15-20 minutes at least 2-3 times per day for relief from discomfort associated with Paraphimosis.

You must choose soft, easy-to-digest foods that are high in protein and fiber, such as yogurt, eggs, fish, nuts, beans, and lean meats. Additionally, make sure you consume lots of water to keep your body hydrated.

In general, it is recommended to avoid eating anything that could irritate or aggravate the affected area in paraphimosis. This includes spicy and acidic foods, as well as any food that is too hot or cold.

The first line of treatment is manual reduction, in which a doctor manually reduces the constricted foreskin to its normal position over the glans penis. In the event that this treatment is unsuccessful, the next available option is surgical intervention.This may involve one of several techniques:

• Circumcision: The surgical removal of the skin that covers the end of the penis is what's known as a circumcision. It is possible that circumcision will be required to allow for appropriate healing and to prevent recurring bouts of paraphimosis.
• Dorsal slit incision: A surgical operation known as a dorsal slit incision is often carried out in order to treat paraphimosis. During this procedure, a very small incision is made on the surface of the foreskin, and the excess skin is removed through this incision. This makes it possible for the foreskin to return to its original position with a greater amount of space. Sutures or staples are typically used to close the incision after it has been made. This procedure can be carried out with the patient only requiring a local anaesthetic, and it typically lasts for about half an hour. Antibiotics might be prescribed afterwards to protect against any potential infections or complications.
• Preputioplasty: A preputioplasty is a surgical procedure that involves repositioning the taut foreskin over the glans after it has been released from behind the glans. During this process, it is possible that any excess foreskin will be removed in order to reduce the risk of future episodes of paraphimosis.

It is possible that one or more of these treatments, when used in conjunction with one another, will produce the desired outcome. In the event that none of these treatments are successful, a more involved procedure, such as an operational release, may need to be carried out.

A person suffering from Paraphimosis should consult a urologist for medical advice and treatment.

The best medicines for Paraphimosis are topical corticosteroids and topical antibiotics. These medications can help reduce inflammation and infection, while also helping to reduce swelling and pain.

In severe circumstances, a topical anaesthetic may even be prescribed by a medical professional in order to alleviate the discomfort caused by paraphimosis.

The length of time it takes to recover from paraphimosis is dependent on the severity of the condition as well as the therapy that was administered. In most cases, manual reduction by a medical professional can reduce swelling and relieve pressure within one to two hours. If manual reduction is not successful, surgical procedures may be required, with recovery times ranging from a few days to several weeks.

The treatment of paraphimosis is usually successful in restoring normal function to the penis, however there is a risk of recurrence.

In order to reduce the risk of recurrence, it is important that patients and clinicians follow up with proper post-treatment care and monitoring. This includes avoiding activities and behaviours that place strain on the penis, keeping the area clean, properly caring for any wound or cuts from treatment, and avoiding any further trauma to the area.

Once the paraphimosis has been reduced, the following post-treatment guidelines should be followed:

• Keep the penis elevated as much as possible to reduce swelling.
• To relieve inflammation and discomfort, apply cold compresses.
• Avoid intercourse or other activities that may cause trauma to the penis for at least one week after treatment.
• Monitor for any signs of infection such as redness, warmth, tenderness or drainage from the site of treatment, and seek medical attention if these symptoms occur.
• Follow up with a doctor in 1-2 weeks after treatment to ensure proper healing has occurred and swelling has gone down.

The cost of paraphimosis therapies in India is determined on the severity of the ailment as well as the type of therapy used.

Generally, a visit to a doctor for diagnosis and medical advice can range from Rs. 500 to Rs. 1000, while medications and ointments could cost anywhere between Rs. 700 to Rs. 2000.

Surgery is usually recommended as a last resort, with costs ranging from Rs. 10,000 to Rs. 20,000 depending on the hospital and other factors such as insurance coverage or discounts offered by the hospital.

The most common side effects associated with paraphimosis treatments include:

• Pain and discomfort at the site of treatment
• Bleeding from the penis or foreskin
• Swelling in the area
• Infection, including inflammation and scarring
• Difficulty urinating or having sexual intercourse
• Damage to the glans of the penis, leading to permanent deformity or loss of sensation.

If you are suffering from any complications relating to Paraphimosis then you should consult a doctor nearby as they can cause complications like swelling, infection, and urethral obstruction, etc., in which treatment course can range from a few months to years depending on the severity of the situation.