When the Foreskin Gets Stuck: Paraphimosis and How To Treat It

Paraphimosis is a condition when the foreskin is stuck behind the head of the penis and cannot be returned to its normal position by covering the tip of the penis. It can cause swelling, pain, and loss of blood flow to the tip of the penis. If one cannot return the foreskin to its original position, serious damage can occur.

Foreskin Is Stuck: Symptoms of Paraphimosis

The main symptoms of paraphimosis are:

• Stuck foreskin and inability to push and return it to its normal position.
• Swelling at the tip of the penis
• Discomfort and pain
• Redness or discoloration and tenderness
• Difficulty in urinating

When these symptoms occur, call your doctor immediately. 

What Causes Paraphimosis? 

An uncircumcised person may pull back their foreskin during sex or when washing the penis. Doctors and nurses may pull open the foreskin when examining the penis or inserting a catheter.

Sometimes you, your doctor, or nurse forget to put the foreskin back. If the foreskin is left behind the head of the penis for an extended period of time, the penis may swell and the foreskin may be trapped behind the penis. 

Other causes of paraphimosis:

• Infection. This can happen if the area is not thoroughly cleaned.
• Injuries in the area. Injuries can occur as a result of intense sexual intercourse, breakthroughs, lesions from repeated infections, or bites of insects or spiders. 
• Circumcision that was not done correctly. 
• Diabetes can cause chronic inflammation of the penis and foreskin. 

Treatment for When the Foreskin Is Stuck

Treatment of paraphimosis consists of reducing penile fluids and returning the stuck foreskin to its original position. There have been no controlled trials available to compare the effectiveness of available treatment options. Doctors may employ several non-invasive or minimally invasive methods to reduce penile swelling.

Due to extreme pain, the person with paraphimosis may require a penile nerve block. They may also need to take local analgesics, or oral anesthetics prior to any procedure. Lidocaine (Emura Cream) applied to the skin for a few minutes to an hour before the penis manipulation is effective. 

What Causes Phimosis and Paraphimosis in Children? 

Phimosis occurs when the opening of the foreskin is stuck or tightens. This is normal for newborn babies. Over time, the foreskin will loosen and can be peeled off more easily. By the age of 17, most boys will be able to fully retract the foreskin.

Phimosis can also occur if the foreskin is pulled back before it is ready. This can lead to the formation of fibrotic scars. This will prevent the foreskin from naturally shrinking to be retractable in the future.

Paraphimosis occurs when the foreskin is retracted behind the crown of the penis. The foreskin then becomes too tight to return to the tip of the penis. 

What Are the Symptoms of Phimosis and Paraphimosis in Children? 

Symptoms may vary slightly from child to child. The most common symptoms of phimosis are:

The most common symptoms of paraphimosis are:

• Swelling of the tip of the penis
• Pain
• Being unable to push the foreskin back to the tip of the penis
• Discoloration on the tip of the penis (usually dark red or blue)
• Pain when urinating
• Reduced urine flow

Consult a doctor for a proper diagnosis. Paraphimosis is an emergency. Seek medical attention immediately if your child appears to have paraphimosis.

Your doctor will check for your child’s symptoms. Then they will ask about their medical history. Your child will also undergo a physical examination, where his penis and foreskin will be checked. 

Paraphimosis Treatment in Children 

Your child’s symptoms, age, overall health, as well as the severity of the condition, will determine the type of treatment needed. Treatment of recurrent paraphimosis also includes:

• Lubricating the tip of the foreskin and penis and gently pushing on the tip of the penis as you tug the foreskin forward
• Making a small cut in the foreskin
• Circumcision

Be sure to talk first with your child’s health care provider about the risks, benefits, and possible side effects of all treatments.

Learn more about Penis Health here.