Phimosis and Paraphimosis – Definition of Causes

Phimosis is a condition when the foreskin of the penis is unable to be pulled to the base of the penis because the penis foreskin is sticky on the inside of the penis due to dirt that is tucked. Phimosis interferes with urination, sexual intercourse, and increases the risk of urinary tract infections. When boys are not circumcised, make it a habit to pull and stretch the foreskin of the penis to the base and to the tip to avoid sticking. But in some people, it may not be able to pull the foreskin completely to the base, and when that happens it is called phimosis.

While paraphymosis is a condition when the foreskin is pulled to the base but it cannot be returned to the tip of the penis so that the foreskin clamps the shaft of the penis, which is an emergency condition because the pinning of the shaft of the penis by the foreskin of the penis itself will cause a blood flow dam and swelling at the tip of the penis, which can lead to penile tissue death due to blood not being able to flow in the penis.

Actually over time, boys before puberty will experience skin retraction (shortening of the foreskin) so that the head of the penis will look naturally. You need treatment only if phimosis occurs after the foreskin is pulled back (past puberty). Or even though the foreskin is not yet interested, but the head of the penis experiences redness, pain, or swelling, phimosis must be treated quickly by circumcision (circumcision).

Causes of phimosis and paraphimosis

There are various possible causes of phimosis, including infections or skin conditions. The diagnosis can be made based on the patient’s medical history. Phimosis only affects uncircumcised men and is more common in men than men.

Normal phimosis in uncircumcised infants and toddlers, because the foreskin is still attached to the gland. It will start releasing naturally between 2 and 6 years, although that might happen later. That can happen in around 10 years, in some boys.

The foreskin can be pulled back behind the glands by about 50 percent of boys aged 1 year, and nearly 90 percent of children aged 3 years. Phimosis will occur in less than 1 percent of adolescents between the ages of 16 and 18.

Most likely to occur in older boys with:

  • Recurrent urinary tract infections
  • Foreskin infection
  • Repeated handling of the foreskin
  • Foreskin trauma

In adults, risk factors for phimosis include sexually transmitted infections.

Phimosis can be caused by skin conditions, such as:

Eczema: A long-term condition that causes itchy, red, dry, and cracked skin.
Psoriasis: This skin condition causes patches of skin to become red, scaly, and crusty.
Lichen planus: An itchy rash that can affect different areas of the body. It is not contagious.
Lichen sclerosus: This condition causes scarring of the foreskin which can cause phimosis. May be caused by urine irritation.

Causes of Paraphimosis


Penile disorders can be caused by one of the following conditions or activities, such as launching Medical News Today:

  • The foreskin that is left stretched long enough can cause swelling. This can occur during a medical examination, after cleaning, or after urinating
  • Tight foreskin pulled causes the penis to swell. This causes the foreskin to not be able to return to its natural position
  • Strong sexual activity, penis piercing, and the use of a narrowed penis ring to increase erections with compression.

Paraphimosis can also result from the following conditions or medical procedures:

  • Infection due to various factors, including poor personal hygiene
  • Scars caused by recurrent infections of the skin of the foreskin, or by forcibly pulling the foreskin on young boys
  • Circumcision that has not been done properly
  • Swelling of the penis and foreskin, due to insect bites or spiders.

Paraphimosis in older men is often caused by one of the following:

  • Diabetes, causes chronic inflammation of the penis and foreskin. This makes paraphimosis more likely
  • Catheterization carried out without the foreskin is returned to its natural position.

In children, the foreskin does not pull at all until about 2 years. Most boys will have a foreskin that can be pulled at the age of 10, and forcibly pulling the foreskin back before it’s ready to do so can cause scarring that can cause paraphimosis.

Other causes of paraphimosis are caused by the following factors:

  • Wrong foreskin handling. Be sure to restore the foreskin position after you, or your caregiver, wash or insert a catheter – a tube that is inserted into the body to expel or enter fluid into the body cavity.
  • Piercing. Pain and swelling from penis piercings (believed to increase sexual arousal) can make it difficult to place the foreskin in place after pulling it back
  • During sex. You might be able to pull your foreskin back to have sex. If the foreskin remains at the base too long, the penis shaft may swell so that the foreskin is trapped
  • Other penis conditions. Other diseases of the penis can cause foreskin problems. For example, phimosis can cause paraphimosis.

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