Correction of paraphimosis

An acute complication of phimosis is paraphimosis, a condition that requires immediate relief. The head of the penis, infringed by the foreskin, without adequate intervention quickly swells, necrotic processes develop. In order to prevent negative consequences, it is necessary to have a clear idea of how to correct paraphimosis. If such help is provided quickly and efficiently, then many problems for men's health can be avoided.

[1], [2]

Indications for the procedure

Paraphimosis is considered one of the complications of phimosis and occurs against the background of its second or third degree. In some cases, the fact of infringement happens and without a complete blockage of blood supply, however, the urethral canal is always transmitted.

To correct paraphimosis should be started immediately, as soon as the following symptoms of an acute complication are revealed:

• acute sudden pain in the head of the penis (less often it increases, gradually increasing, but still manifests itself sharply);
• increasing swelling of the penis (especially prominent and swollen rounded roller along the coronal sulcus);
• ischemic processes in the distal or terminal portion of the penis, which are accompanied by darkening or blueness of the skin;
• forced pose of a person to ease the pain syndrome (the victim, as a rule, puts his legs to the side and leans forward as much as possible);
• urination is very difficult, or impossible.

The painful symptoms presented above are an indication for immediate measures to correct paraphimosis.

[3], [4], [5]

Preparation

Since the adjustment of paraphimosis is an emergency measure, special preparation is not required: it is important to carry out the procedure as soon as possible. If possible, the head of the penis is treated with vegetable or petrolatum oil, or baby cream, or plain water. Again, if there is a need and opportunity, anesthesia is carried out. But, as with paraphimosis the account goes for minutes, the correction is carried out even in the absence of oils, creams and other means.

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Technique of the repositioning of paraphimosis

Paraphimosis can sometimes be adjusted independently: it should be done immediately - the sooner, the better. If you fix the problem in 1-2 minutes, you can avoid the appearance of swelling and severe pain.

To increase the effectiveness of the procedure and alleviate the pain, you need to apply a little vaseline or vegetable oil, or a baby cream, to the penis head. In the process of correction, the pain will increase, so you need to be ready for it. If the paraphimosis could not be corrected for three or four minutes, it is better not to waste time, but to urgently consult a medical specialist. It should be borne in mind that this condition is really urgent, and even ten minutes is enough to cause necrotic disorders in the tissues of the head and foreskin.

Qualified correction of paraphimosis can be done by a surgeon, using local anesthesia with novocaine or lidocaine. With paraphimosis in childhood, there is sometimes a need for general anesthesia.

Previously, the doctor will try to correct the problem manually: in the absence of a positive result, a small surgical procedure is performed, the essence of which is to dissect the foreskin with further insertion of the head. With this development, the patient will experience a recovery period with the use of non-steroidal anti-inflammatory drugs and the local application of antimicrobial external agents. In addition, it is recommended to irrigate and wash the head with disinfectant solutions - for example, a weak solution of potassium permanganate or furacilin.

Manual adjustment of paraphimosis is a one-stage removal of pinching: the head is pushed through the restrained ring, and the foreskin returns to its original place. In most cases, this procedure is done without anesthesia, only sometimes you have to resort to non-long-term methods of analgesia.

The technique of correction is as follows:

• the victim is laid horizontally, if necessary, fixed;
• the head with the foreskin is treated with vaseline or vegetable oil;
• a person who guides the paraphimosis, places the thumbs on the head of the penis, while others grab the restrained ring;
• gently, without excessive force, you should press on the head, trying to push it through the hole, after which you need to push the skin of the foreskin onto it.

Do not pressure the head with sharp and vigorous jerks. It is better to provide a constant slight pressure, which will help reduce the swelling of the head to its free passage through the restrained ring.

After successful manual adjustment of paraphimosis, the affected person should do penile lavage with warm water with a weak solution of potassium permanganate, twice a day until relief of painful symptoms.

Contraindications to the procedure

Steer paraphimosis is carried out as soon as possible to prevent the development of necrosis or gangrene of tissues. If necrotic processes have already developed, then further attempts to restore control are contraindicated: it is urgent to hospitalize the victim. In the hospital he will be provided with emergency surgical care.

[7], [8],

Consequences after the procedure

The correction of paraphimosis is always necessary, since this state is classified as critical and has all the chances to result in unpleasant consequences. If you do not take timely measures, the patient can seriously damage his health and even lose his reproductive organ.

The compression of the head leads to a persistent disruption of the blood supply of the tissues. If the integument of the head has acquired a cyanotic, dark or purple color, this indicates the development of necrotic processes - simply speaking, the necrosis of the tissues begins. The consequences of such processes can be easily guessed: it is an operation to amputate the head or the entire organ. Such intervention is carried out with the purpose of saving the life of the victim: the question of preserving the body in such a situation is no longer considered.

Necrotic changes can also develop with paraphimosis in childhood. Therefore, in no case should parents hesitate to call the ambulance.

Complications after the procedure

After successful correction of paraphimosis, the patient can for some time detect such symptoms:

• weak pain;
• small swelling of the organ head region;
• increased sensitivity of the penis.

These signs are considered quite adequate: they will be held for several days. If you ignore the advice of a doctor and neglect the rules for caring for the sexual organ after restoring paraphimosis, complications in the form of spread of infection can develop.

It is necessary to consult a doctor if such symptoms appear:

• the head is swollen, red, there is pain;
• The discharge appeared from the sexual organ;
• the penis covered with spots of cyanotic or brownish color;
• the temperature increased, overall health worsened.

After correcting paraphimosis complications are rare, but you should not forget about them. Negative consequences can adversely affect not only the state of health of a person, but also the possibility of further sexual behavior.

[9], [10], [11], [12]

Care after the procedure

If manual repositioning of paraphimosis is successful, the penis is elevated, fixing it to the abdomen. This ensures an early removal of puffiness. In the future, the patient is recommended to treat the penis twice a day with disinfectant solutions to avoid infection and the development of inflammatory processes. Optimum for the treatment of the body to use a weak solution of potassium permanganate, furacilin.

• If necessary, the patient takes painkillers (analgin, ibuprofen, etc.).
• For two days the patient should rest, avoid active sports, do not run and walk less.
• You should follow all the advice of a doctor for the treatment of the sexual organ.
• Sexual contact until the tissue of the organ is fully restored, are prohibited.
• If, against the background of healing, the patient has a painful erection, then an ice compress should be applied to the genitals, to eliminate pain sensations.
• If paraffimosis was given to the child, then at the stage of recovery for some time, it is advisable to apply a bandage.

[13],

Reviews

According to numerous reviews, one important conclusion can be drawn: in paraphimosis, the main thing is to act clearly and immediately, because such a problem is really urgent. Already for ten minutes, signs of necrosis may appear: tissue dying begins, which later will have to be removed promptly.

If the patient or his relatives can not solve the problem on their own and quickly, then do not waste time: it is better to call "emergency help" as soon as possible and to entrust the problem to the medical specialist. Timely adjustment of paraphimosis allows to eliminate the threat to the life and health of the victim, however, it needs to be done during the first few minutes.