The frequency of diagnosis is 1-2% in men, both in adults and in children. Pathology is characterized by a sudden onset of an acute course and requires urgent medical attention.
What is paraphimosis?
Paraphimosis is a pathological condition of the penis, in which the glans is squeezed in a circle by a narrowed foreskin retracted beyond the coronal sulcus. In this case, spontaneous displacement of the preputial tissue to its original position is impossible.
Pathology is a complication of phimosis - the narrowness of the foreskin, which prevents the natural removal of the head of the penis. When trying to expose it by self-retraction, the likelihood of paraphimosis increases several times.
Reasons
Paraphimosis in children is often the result of physiological phimosis. We are talking about a natural process, which is characterized by an epithelial adhesion of the head of the penis and the inner cover of the foreskin. Normally, this condition is observed in boys in the first years of life. At the age of 3 to 7 years, spontaneous opening of the preputial sac occurs.
However, with premature forced displacement of the preputial tissue, paraphimosis most often occurs. The pretext for such actions may be hygienic procedures. As a result, traumatization occurs, a decrease in the elasticity of the displaced integuments, which makes it difficult to reverse movement.
In adult men, pathology develops due to several predetermining factors. A short frenulum often causes the foreskin to be difficult to reverse displacement. It is also possible that the disease occurs due to an injury received during intercourse or masturbation.
Concomitant pathologies, such as heart failure and diabetes mellitus, are also prerequisites for the formation of a paraphimous ring. Edema, microcirculation disorders, characteristic of these diseases, reduce the elasticity of tissues, making them vulnerable to various kinds of injuries. As a result, scars are formed that impede the natural movement of the skin. Cicatricial seals also often become a consequence of past inflammatory diseases: balanitis, balanoposthitis.
Performing medical manipulations (catheterization, cystoscopy, ureteroscopy), during which the head of the penis is deliberately exposed, is also fraught with the appearance of pathogenesis if the shifted flesh is not returned to its original position for a long time.
Symptoms
The syndrome of pathology manifests itself immediately. Infringement of the head with a stenosing ring leads to stagnation of the lymph and blood flow, the formation of pronounced edema. The area of circular compression resembles a swollen roller, the head is enlarged in size and acquires a bluish tint. The slightest touch of the genitals causes severe pain, urination is difficult (children have acute urinary retention).
Paraphimosis, the symptoms of which are caused by a change in the color of the head from bluish to purple-black, accompanied by the cessation of pain, requires emergency surgical intervention. After all, these signs indicate the development of necrosis. In the most extreme case, the condition may be complicated by the development of ischemic gangrene of the area of paraphimous clamping. At the same time, partial amputation of the glans penis is not ruled out.
Diagnosis
When paraphimosis is diagnosed - "What is it?" and “How to treat it?” - the most asked questions. Answering them, the doctor is guided by the results of the survey, allowing him to choose the best type of therapy.
No specific monitoring is required to make a diagnosis. Symptoms of pathogenesis are visible to the naked eye and do not need additional confirmation.
At the initial examination, the doctor collects an anamnesis to determine the time since the onset of the development of the pathology, the features of the course, and possible causes. If this is an acquired phimosis, which resulted in a prolonged compression of the glans penis, then ultrasound may be prescribed to determine the severity of the condition.
