Paraphimosis is a urologic emergency , which results exclusively in uncircumcised or part circumcise penis . It pass when the foreskin in these males remains forswear for an extensive period of sentence and there is trouble in its successor to normal anatomical position . The drawn-out retraction of the prepuce run to venous occlusion , edema and arterial occlusion . This reform-minded dropsy of the foreskin owe to venous and arterial block is the main cause behind non - reducing of foreskin over the glans penis .
If paraphimosis is not treated too soon then it might compromise the blood flow to the glans run to tightness , which may contribute to gangrene and finally amputation of the glans penis .
What Causes Paraphimosis?
Paraphimosis is a comparatively uncommon condition . Generally , paraphimosis is induce unwittingly , but there have been reported cases of coital stimulate and penial piercing that might direct to paraphimosis and ultimately necrosis of the glans phallus . It is more prevalent in hospitals and breast feeding home and appears when a person or a parent retracts the prepuce and inadvertently leave the foreskin retracted . Generally , the draw in foreskin follow back to its anatomical posture ; however , if there is some resistance in reduction of the foreskin , there is a greater chance of developing eternal edema of the prepuce , thus predisposing to paraphimosis . Paraphimosis is more unwashed in communities in uncircumcised or partially circumcised male .
In most instances , paraphimosis occurs after retracting the foreskin at the metre of penile examination , cleaning of the glans penis , cystoscopy or urethral catheterization . It is of utmost importance for both the health care professionals as well as the patient to restore the recant prepuce to its anatomic side to preclude paraphimosis .
Paraphimosis following urethral catheterization is a common cognitive process as prior to the introduction of a catheter , the doc has to retract the foreskin to prepare and clothe the glans phallus . The retracted prepuce may be pass on in the retracted stead inadvertently for hours to days . This might rule out the development of paraphimosis .
There are other less common cause of paraphimosis that can lead to this consideration . These let in Plasmodium falciparum infection , contact dermatitis ( follow the app of celandine succus to the prepuce ) , ego - infliction ( such as after piercing with a penial annulus into the glans ) , erotic dancing or Haemophilus ducreyi ( chancroid ) infection .
Anatomy of Penis
The penile structure is disunite into three main portions , which admit root of the penis , soundbox of the phallus and glans penis that form the distal end of the phallus . The root of the penis is found under the pubic off-white providing constancy to the erect phallus . The body of the member forms the major parcel of the penis and consist of cavernosal body including corpora cavernosa and corpus spongiosum . The cavernosal bodies are creditworthy for an hard-on when they are filled with pedigree . The glans forms the distal extension of corpus spongiosum , which is cover by a loose skin get laid as foreskin in uncircumcised men . Coronal sulcus forms a neckband of tissue immediately behind the glans .
Penis is a very vascular structure , which is cater by inner pudendal artery that arises from internal iliac artery branching into deep penial arteria ( issue corpus cavernosum ) , urethral arteria ( supplying glans phallus and corpus spongiosum ) and bulbar arteria ( supplying bulbar urethra and bulbospongiosus muscularity ) . It is also innervate by left and ripe dorsal nerves of pudendal brass .
Pathophysiology Behind Paraphimosis
When the prepuce is forswear behind the glans for a protracted period of time , it forms a tight band of tissue around the penis . Initially , this tight band of tissue paper or constricting ringing impairs the venous blood and lymphatic flow from the glans phallus and prepuce , which ultimately go to edema of glans penis . As there is worsening of the edema , the arterial line of descent flowing is also compromised . This vascular impedimenta along with tissue ischemia leads to painful swelling of the foreskin and glans phallus , which eventually causesgangreneand autoamputation of the distal penis .
