What is paraphimosis or how to prevent the death of male dignity?
Good day. Alexander Burusov, an expert at the men's club & # 171, Viva Meng & # 187, writes to you. Today we have paraphimosis on the agenda. Let's find out why this disease occurs, how it proceeds, and what methods of its treatment exist.
What is paraphimosis?
This disease has been known for a long time and in common people for external resemblance is called a noose or a Spanish collar.
Paraphimosis is an acute violation of the function of the male genital area. The reason is the circular compression of the head of the penis with the foreskin. This emergency condition occurs when the foreskin is inserted behind the coronal groove, when its independent return to the physiological position is impossible.
The causes of the disease
The main reason for the formation of this pathology becomes phimosis , a common pathology in which there is no way to expose the glans penis. The danger increases with a congenital short and rigid (inextensible) frenulum of the foreskin
Paraphimosis can be the result of too dynamic masturbation or hard intimate contact.
The formation of this pathology is facilitated by cicatricial deformity of the foreskin after untreated inflammatory diseases: the head (balanitis), a leaf of the foreskin (post), sexually transmitted diseases (including primary syphilis).
Local genital allergic reactions, systemic skin diseases appearing on the foreskin and deforming it, complicated medical urological procedures (catheter insertion, cystoscopy), phallus piercing are all risk factors for the development of paraphimosis.
The severity of manifestations of paraphimosis is due to the time elapsed since the strangulation of the head of the phallus.
The onset of manifestations is acute. There is discomfort, a feeling of pressure on the penis and increasing local changes. The pain increases in waves and intensifies when you touch the head. The victim takes a forced position with the torso tilted forward and legs apart, only in this position does the patient feel some relief.
If help is not provided, the edema of the head increases significantly, it becomes crimson with a bluish-violet hue. This is a manifestation of stagnation of venous blood and lymph in the transferred head. Arterial blood, rich in oxygen and nutrients, ceases to flow into it.
Then the edema of the foreskin joins, it becomes like an inflated lifebuoy under the head of the penis, greatly enhancing its compression. Urination is difficult (up to a complete delay) and extremely painful.
The proximal, adjacent to the body, part of the penis is not changed.
With paraphimosis, a feeling of severe pain is evidence of the viability of the tissues of the penis. Pain Relief - terrible sign death of nerve endings and tissue necrosis.
The time interval from the onset of manifestations to the subsidence of pain can be from 40 minutes to several hours.
Without medical assistance due to the cessation of blood flow to the affected area, necrosis of the tissues of the head of the penis occurs. Ulcerations, a specific putrefactive odor appear, with the development of gangrene, symptoms of general intoxication of the body (fever up to 38-39 °, weakness, muscle and joint pain) join.
Less frequent complications of paraphimosis can be gangrene of the foreskin ring, dying off and partial self-amputation of the affected area of the penis.
A physician is responsible for assisting with this disease: surgeon, andrologist or urologist.
The basis for establishing a diagnosis is the collection of an anamnesis (when squeezing occurred, how the poppy was released earlier) and examination of the genital organ. As a rule, no difficulties arise due to the characteristic symptoms.
At the first symptoms it is necessary reduce swelling and relieve pain: apply cold to the compression site (ice pack or cold compress), local anesthetics can be used. For the same purpose, you can apply applications with a hypertonic solution (2 teaspoons of salt without a slide in a glass of water). An elastic compression bandage can be applied to reduce stagnation in the transferred head.
The head of the penis is inserted into the foreskin ring, having previously performed local anesthesia and lubricated the skin with glycerin or liquid paraffin. After reduction, they recommend the application of hormonal ointments, baths with antibacterial and anti-inflammatory drugs, injections of enzyme preparations that increase the permeability of connective tissue. These activities contribute to the recovery processes in the glans penis.
Surgery is necessary if the previously mentioned measures are ineffective.
If reduction is not possible, make a longitudinal incision of the foreskin ring and release the pinched area.
To prevent a recurrence of strangulation, approximately 6 months after the extinction of acute manifestations is carried out circular excision of the foreskin, mainly using a radiosurgical scalpel or using a laser.
In the case of tissue necrosis or the threat of gangrene, resection of dead tissue is performed surgically. In order to avoid postoperative complications, antibacterial and immunostimulating therapy is carried out.
The key rules of prevention include the following rules:
- Boys from an early age need to be trained in proper intimate hygiene, not to try to forcibly expose the poppy.
- Adolescents and adults should be prudent during intimacy and masturbation.
- Medical procedures should only be performed in the presence of a doctor.
- Timely and high-quality treatment of infectious and inflammatory diseases of the genitourinary sphere.
- Regular annual preventive examinations, and men with diabetes should take it every three, six months.
Phimosis and paraphimosis - how do they differ?
The easiest way to talk about paraphimosis is to draw an analogy with phimosis - its forerunner. Phimosis is a narrowing of the foreskin, in which it is impossible to expose the glans penis either in its entirety, or only halfway, or in its entirety, but not in an erection state.
This problem is traditionally solved by circumcision, less often by medical and non-drug therapies, such as, for example, the gradual stretching of the foreskin by hand or using a special silicone ring, or the use of ointments that increase skin elasticity.
It is known that not all men treat phimosis, many live with this pathology all their lives or go to the doctor only when complications begin. It’s easier to answer the question “What is paraphimosis?”, Saying that this is one of the possible complications of phimosis. And with that, and with another disease, the man faces a single problem - the inability to “move” the foreskin. Only with phimosis, problems arise when trying to "bare" the glans penis, and with paraphimosis - "close" it.
With this pathology (paraphimosis), the foreskin forms a dense ring that compresses the penis and complicates blood circulation.
Paraphimosis in boys - vigilance and caution
Paraphimosis occurs in both adult men and children. However the child is much more at risk.
Infringement can occur with masturbation, hygiene procedures, the parent himself can also cause harm, who, when bathing a small child, will try to pull out the head of the penis with effort to wash it.
It is worth remembering that the glans penis should be free to “open” and “close” by two or three years, before this age phimosis can be called physiological, but by the age of six to seven it becomes a pathology that needs attention. It’s worth running ahead and noting - paraphimosis in children is operated on under general anesthesia.
What are the causes of paraphimosis?
For the time being, complications with phimosis may not occur. Forced removal of the glans penis from a narrowed and sedentary foreskin is the main cause of paraphimosis. It can be triggered by masturbation, sexual intercourse, hygienic procedures, when in order to move the foreskin a force is applied. Head compression can also occur in the following cases:
- during medical manipulations with the penis, requiring "opening" of the head for a long time (such procedures include, for example, catheterization and cystoscopy),
- quite rarely with genital allergies and primary syphilis, when there is edema that prevents the foreskin from returning to its original state.
What could be the consequences of the disease?
The consequences of untreated paraphimosis on time can be very serious. If the pain has passed, and the foreskin has not been returned to its place - this is a very bad sign. This can only mean one thing - necrosis has begun, that is, the necrosis of head tissue.
This process is irreversible and it is no longer possible to save the organ, therefore it must be amputated. If you simply drag out the trip to the doctor and visit the doctor while the pain has not yet subsided, there may be a strong infection of the ulcers that arise, resulting in severe inflammation, which is extremely difficult to predict.
With an immediate visit to the doctor, such terrible consequences can of course be avoided, this problem is solved without new complications if treatment is started on time.
How is paraphimosis diagnosed?
You can diagnose paraphimosis yourself, if somewhere you once had a chance to read about it. The fact that the glans penis swells and the foreskin forms a ring that compresses the glans at its base.
When contacting a doctor, the diagnosis does not cause any problems. The conclusion is made by a urologist or surgeon after examining the penis and talking with the patient.
Miracle herbs, fees, ointments with paraphimosis do not help. Traditional medicine is powerless here, and if such a pathology occurs, the patient has one way - to the doctor. Treatment of paraphimosis in neither men nor boys at home is impossible, except for the bloodless method described below. But it’s still better to entrust this work to a specialist, since they already know how to treat paraphimosis.
With paraphimosis, the surgeon will help the patient, but he can do this in two ways. There is an option to avoid surgery and deal with the problem bloodlessly, in the same way that a man could already try to solve the complication at home. This is a kind of reduction of paraphimosis.
Anesthetic is injected into the area of the base of the penis (children, however, are most often given general anesthesia), after which the surgeon manually tries to advance the head of the penis into the infringing ring. If you can’t do this in such a conservative way, you have to operate on the organ.
The compression ring is incised or dissected, the wound is treated and a bandage is applied to it. If incisions were made, then the patient is allowed to go home, where he must make baths or rinses.
If during the operation a significant part of the foreskin is excised or removed (actually circumcision), in the case when the patient did not seek the help of surgeons on time, he will be left in the hospital for a certain time to observe the healing process.
If you still managed to straighten the head manually, then we must not forget that such an incident can happen again, therefore, you should definitely think about further actions related to the treatment of phimosis. But this is a matter of prevention.