Paraphimosis: Clinical manifestations, diagnosis, and treatment
- Matthew Tews, DO
Matthew Tews, DO
- Professor of Emergency Medicine
- Medical College of Georgia
- Jonathan I Singer, MD
Jonathan I Singer, MD
- Section Editor — Pediatric Surgical Emergencies
- Professor of Emergency Medicine and Pediatrics
- Wright State University Boonshoft School of Medicine
- Section Editors
- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr., MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
- Anne M Stack, MD
Anne M Stack, MD
- Section Editor — Pediatric Procedures
- Associate Professor, Department of Pediatrics
- Harvard Medical School
- Jerome P Richie, MD, FACS
Jerome P Richie, MD, FACS
- Section Editor — Cancer of the Urethra, Penis, and Ureter; Urologic Surgery; Prostate Cancer
- Elliott Carr Cutler Professor of Surgery
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This topic discusses the clinical features, diagnosis, and treatment of paraphimosis.
Other pathologic conditions of the foreskin (eg, phimosis) and the care of the uncircumcised penis are discussed separately. (See "Care of the uncircumcised penis in infants and children", section on 'Pathologic conditions' and "Care of the uncircumcised penis in infants and children" and "Balanitis in adults".)
The terms paraphimosis and phimosis are often confused:
●Paraphimosis refers to a retracted foreskin in an uncircumcised or partially circumcised male that cannot be returned to normal position (picture 1).
●Phimosis is defined as a tight foreskin that cannot be retracted to expose the glans penis. In young children, phimosis is normal or physiologic. In older patients, infections such as balanoposthitis or other inflammatory conditions result in scarring and pathologic phimosis that requires urologic referral. (See "Care of the uncircumcised penis in infants and children", section on 'Physiologic phimosis' and "Care of the uncircumcised penis in infants and children", section on 'Pathologic phimosis' and "Balanitis in adults", section on 'Phimosis'.)
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- CLINICAL FEATURES
- Physical examination
- DIFFERENTIAL DIAGNOSIS
- Indications for specialty consultation
- Paraphimosis reduction
- - Manual reduction
- Pain control
- Methods to reduce swelling
- - Dorsal slit reduction
- - Other techniques
- - Complications
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS