Paraphimosis is the inability of an uncircumcised male to pull the retracted foreskin over the head of the penis.

Paraphimosis and phimosis are related conditions caused by inflammation and narrowing of the foreskin. The inflammation may be caused by infection and may be associated with poor personal hygiene. Occasionally inflammation develops after direct trauma to the area, which results in swelling. Uncircumcised males -- and those who may not have been appropriately or completely circumcised -- are at risk.

The strictured foreskin is retracted behind the glans penis and left there for some period of time. The retracted foreskin and glans become swollen, making it difficult to return the foreskin to its extended position. If paraphimosis is left untreated, the blood flow to the glans is impaired. In extreme cases, this may result in loss of the penis tip.

Paraphimosis occurs most often in children and the elderly.

• Inability to pull the retracted foreskin over the head of the penis
• Painful swelling at the end of the penis
• Penis pain

A physical examination confirms the diagnosis. The usually finding is the appearance of a "doughnut" around the shaft near the head of the penis (glans).

Compression of the head of the penis while applying forward traction on the foreskin may reduce the swelling due to paraphimosis. If this fails, prompt surgical circumcision will be necessary.

The probable outcome is excellent if the condition is diagnosed and treated rapidly.

If the condition is not relieved rapidly, gangrene or permanent damage to the penis may occur.

Go to your local emergency room if this occurs.

Circumcision, when performed properly, prevents the development of this condition.