{"id":5047,"date":"2022-05-14T11:50:57","date_gmt":"2022-05-14T04:50:57","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=5047"},"modified":"2026-08-27T20:20:07","modified_gmt":"2026-08-27T13:20:07","slug":"paraphimose-urologischer-notfall","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/de\/2022\/05\/14\/paraphimosis-urologic-emergency\/","title":{"rendered":"Paraphimosis: A Trapped Foreskin Is an Emergency \u2014 Go Now"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" 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Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=12%2C12&amp;ssl=1 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behind the head of the penis acts as a tightening band: the head swells, which tightens the band further, which increases the swelling. It gets worse by the hour on its own.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In Thailand, call <strong>1669<\/strong>. While you are getting there:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stop trying to force it forward.<\/strong> Repeated forceful attempts add swelling and make the reduction harder when you arrive.<\/li>\n\n\n\n<li><strong>Do not put anything tight around it<\/strong> \u2014 no rubber band, no string, nothing improvised to hold it.<\/li>\n\n\n\n<li>Lying down with the area supported and slightly raised is reasonable while you travel.<\/li>\n\n\n\n<li>Say the word <strong>paraphimosis<\/strong> at the desk. It is recognised immediately and it is not a condition that waits in a queue.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">A correction to the timing given here previously<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">An earlier version of this article said that if the condition <em>persists for days<\/em>, arterial supply becomes compromised and the head of the penis can be lost. The end point is right and <strong>the timescale was dangerously reassuring.<\/strong> Paraphimosis is reduced within <strong>hours<\/strong>. A man who reads <em>days<\/em> and decides to see how it looks in the morning has been given exactly the wrong impression, and that sentence has been replaced.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"600\" data-attachment-id=\"5069\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2022\/05\/14\/paraphimosis-urologic-emergency\/emergency-condition\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?fit=1200%2C900&amp;ssl=1\" data-orig-size=\"1200,900\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Paraphimosis is a true Urologic emergency.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Paraphimosis is a true Urologic emergency.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?fit=800%2C600&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=800%2C600&#038;ssl=1\" alt=\"Emergency department, where a trapped foreskin needs to be reduced within hours\" class=\"wp-image-5069\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=1024%2C768&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=16%2C12&amp;ssl=1 16w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Emergency-condition.jpg?resize=750%2C563&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">This is one of the few genuinely time-critical conditions in urology.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What is actually happening<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The foreskin has been pulled back behind the head of the penis and cannot be brought forward again. The ring of foreskin behind the glans squeezes the tissue in front of it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The veins and lymphatics are squeezed shut first, while the arteries \u2014 thicker-walled and at higher pressure \u2014 keep pumping blood in. Blood arrives and cannot leave, so the head swells, and the swelling tightens the ring further. That self-worsening loop is why the condition does not settle by itself and why waiting makes reduction harder rather than easier. If it continues long enough the arterial supply does eventually fail, and tissue is lost.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It affects <strong>uncircumcised men<\/strong>, and it is more likely where the foreskin is already somewhat tight.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How it happens \u2014 and the commonest cause of all<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version listed the causes as a flat list. One of them deserves to be first, because it is the one that is entirely preventable and the one that happens to people who cannot speak up for themselves.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A foreskin retracted to insert a urinary catheter, and then not put back.<\/strong> This is the classic scenario \u2014 in an emergency department, on a ward, in a care home \u2014 and the patient is often elderly, confused, sedated or unable to complain. Hours pass before anyone looks. <strong>Anyone caring for a man with a catheter should check that the foreskin is forward<\/strong>, and anyone inserting one should replace it immediately afterwards. The same applies after a bladder examination or any procedure through the urethra.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The other routes:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Retraction for washing<\/strong>, and forgetting to return it \u2014 commonest in men who have recently started retracting a foreskin that was previously tight.<\/li>\n\n\n\n<li><strong>After sexual activity or masturbation<\/strong>, when swelling makes it harder to bring forward.<\/li>\n\n\n\n<li><strong>In boys<\/strong>, when a foreskin is retracted forcibly by a parent or carer \u2014 a childhood foreskin that does not retract is usually normal and should not be forced.<\/li>\n\n\n\n<li><strong>Genital piercings or rings<\/strong>, and rarely a severe infection causing sudden swelling.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"5068\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2022\/05\/14\/paraphimosis-urologic-emergency\/hmm-need-think-up-plan-portrait-of-determined-and-thoughtful-creative-perplexed-guy-smirking-rubbing-beard-thoughtful-looking-right-while-making-up-idea-trying-solve-troublesome-situation-2\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;4.5&quot;,&quot;credit&quot;:&quot;Seva Levitsky&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark III&quot;,&quot;caption&quot;:&quot;Hmm need think up plan. Portrait of determined and thoughtful creative perplexed guy smirking rubbing beard thoughtful looking right while making up idea trying solve troublesome situation. Copy space&quot;,&quot;created_timestamp&quot;:&quot;1325908556&quot;,&quot;copyright&quot;:&quot;Cookie Studio 2017&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;100&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;Hmm need think up plan. Portrait of determined and thoughtful creative perplexed guy smirking rubbing beard thoughtful looking right while making up idea trying solve troublesome situation&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Most of paraphimosis issues happen from man-made situations.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Most of paraphimosis issues happen from man-made situations.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Man concerned about a foreskin that will not return forward over the glans\" class=\"wp-image-5068\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Curious-man.jpg?resize=750%2C500&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Almost every case begins with a foreskin retracted and not returned \u2014 which is what makes it preventable.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Severe pain, and a band of tight foreskin visible behind a swollen head.<\/li>\n\n\n\n<li>The head becoming increasingly swollen, red and shiny.<\/li>\n\n\n\n<li><strong>The head turning dusky, blue, dark or cold<\/strong>, or the pain lessening while the appearance worsens \u2014 this means the blood supply is failing and is the most urgent possible presentation.<\/li>\n\n\n\n<li><strong>Difficulty or inability to pass urine.<\/strong><\/li>\n\n\n\n<li>In someone who cannot report symptoms \u2014 an elderly or confused patient \u2014 <strong>new agitation, or pulling at a catheter<\/strong>, is a reason to look.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Treatment<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Most cases are reduced by hand<\/strong>, with pain relief or sedation and after the swelling has been reduced by steady compression. It is uncomfortable, it takes a few minutes, and it resolves the emergency completely.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Where that fails \u2014 usually because too much time has passed \u2014 a <strong>small incision in the constricting band<\/strong> releases it immediately, under local anaesthetic. Where tissue has already been lost, the operation is larger, and this is precisely the outcome that arriving early avoids.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">None of this is something to attempt at home beyond a single gentle attempt to bring the foreskin forward. Repeated forceful attempts make the swelling worse.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"5070\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2022\/05\/14\/paraphimosis-urologic-emergency\/surgeon-cutting-cotton-from-scissor-in-operation-room-2\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Surgeon cutting cotton from scissor in operation room at hospital&quot;,&quot;created_timestamp&quot;:&quot;1470109064&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Surgeon cutting cotton from scissor in operation room&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"All patients with a history of this should consider elective circumcision.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;All patients with a history of this should consider elective circumcision.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Operating theatre, where a constricting foreskin band is released if manual reduction fails\" class=\"wp-image-5070\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2022\/05\/Paraphimosis-surgery.jpg?resize=750%2C500&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">If manual reduction fails, releasing the band takes minutes under local anaesthetic.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Afterwards: does everyone need a circumcision?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version of this article said all patients with a history of paraphimosis are recommended to be circumcised. <strong>That is close to right and slightly too absolute, and it has been softened.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Circumcision is the definitive way to make recurrence impossible, and it is the usual recommendation \u2014 particularly where <strong>the foreskin was already tight<\/strong>, since that man will meet the problem again. But where the episode had a clear one-off cause that has been corrected \u2014 a catheter retraction, a single procedure \u2014 the decision is more open, and a foreskin-preserving operation is an alternative worth asking about.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What is not reasonable is doing nothing and hoping. See <a href=\"https:\/\/drsoaraweeurology.com\/2022\/04\/29\/circumcision-stapler\/\">how the circumcision techniques compare<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Paraphimosis<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Can it wait until morning?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. It tightens by the hour because the swelling it causes makes the constriction worse, so it does not settle by itself and reduction becomes harder the longer it is left. Reduction is a matter of hours. An earlier version of this article referred to damage occurring over days, which was too reassuring and has been corrected.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What is the commonest cause?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A foreskin retracted for a urinary catheter or an examination and not replaced afterwards. The patient is often elderly, confused or sedated and cannot report it, so anyone caring for a man with a catheter should check that the foreskin is forward.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can I push it back myself?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">One gentle attempt is reasonable. Beyond that, repeated forceful attempts add swelling and make the hospital reduction harder. Do not apply anything tight around it, and go in.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How is it treated?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Most cases are reduced by hand after pain relief and steady compression to reduce the swelling. If that fails, a small incision releases the constricting band under local anaesthetic. Where tissue has already been lost, more extensive surgery is needed \u2014 which is what early arrival prevents.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Will I need a circumcision afterwards?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Usually it is recommended, since it makes recurrence impossible \u2014 especially if the foreskin was already tight. Where the episode had a clear one-off cause that has been corrected, the decision is more open and a foreskin-preserving operation may be an alternative. Doing nothing is the option that is not reasonable.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My son&#8217;s foreskin will not pull back. Should I retract it?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. A childhood foreskin that does not retract is usually normal and separates in its own time. Forcing it is one of the ways paraphimosis happens in boys, and it can also cause scarring that creates a genuine problem where none existed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>An episode happening now goes to an emergency department, not to an appointment.<\/strong> Afterwards, to discuss preventing recurrence, Dr. Soarawee Weerasopone sees patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for non-urgent consultations, including for international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/05\/14\/paraphimosis-urologic-emergency\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2022\/05\/14\/paraphimosis-urologic-emergency\/\",\n      \"name\": \"Paraphimosis: A Trapped Foreskin Is an Emergency \u2014 Go Now\",\n      \"description\": \"A retracted foreskin that cannot be returned constricts the glans and worsens hour by hour. Reduction is required within hours, and the commonest cause is a foreskin retracted for catheterisation and not replaced.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2022-05-14\",\n      \"dateModified\": \"2026-08-27\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/05\/14\/paraphimosis-urologic-emergency\/#paraphimosis\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"The earlier version stated that arterial compromise and glans loss follow if the condition persists for days. The timescale was dangerously reassuring and has been corrected: reduction is required within hours, since the swelling caused by the constricting band progressively worsens the constriction. The article previously opened with aetiology rather than instruction; emergency guidance now leads the page, including not making repeated forceful attempts, applying nothing constricting, and naming the condition on arrival. Catheter-related retraction without replacement has been promoted to the leading cause, since the patient is frequently elderly, sedated or confused and unable to report it. Forced retraction in boys, and the advice not to retract a child's foreskin, were absent. The recommendation that all patients undergo circumcision has been softened: it remains usual, particularly with pre-existing phimosis, but a corrected one-off cause leaves the decision more open and foreskin-preserving surgery is an alternative.\"\n    },\n    {\n      \"@type\": \"MedicalCondition\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/05\/14\/paraphimosis-urologic-emergency\/#paraphimosis\",\n      \"name\": \"Paraphimosis\",\n      \"description\": \"A retracted foreskin that cannot be returned over the glans, forming a constricting band that occludes venous and lymphatic drainage while arterial inflow continues. The resulting oedema tightens the band further, producing a self-worsening cycle.\",\n      \"cause\": \"Foreskin retraction without replacement, most often during urinary catheterisation, urethral instrumentation or examination; retraction for hygiene; after sexual activity; forcible retraction of a child's foreskin; and rarely genital rings or severe infection. Occurs in uncircumcised males and is more likely with pre-existing phimosis.\",\n      \"signOrSymptom\": \"Severe pain with a visible constricting band behind a swollen, erythematous glans. A dusky, dark or cold glans, or diminishing pain with worsening appearance, indicates failing perfusion. Difficulty voiding may occur. In patients unable to report symptoms, new agitation or catheter interference should prompt inspection.\",\n      \"possibleComplication\": \"Progressive oedema, arterial compromise, glans necrosis and tissue loss. Urgency is measured in hours rather than days.\",\n      \"possibleTreatment\": {\n        \"@type\": \"MedicalProcedure\",\n        \"name\": \"Manual reduction, or dorsal slit release of the constricting band where reduction fails\",\n        \"howPerformed\": \"Manual reduction after analgesia or sedation and sustained compression to reduce oedema. Where unsuccessful, incision of the constricting band under local anaesthetic provides immediate release. Debridement is required where necrosis has occurred. Elective circumcision is usually recommended to prevent recurrence, particularly with pre-existing phimosis; foreskin-preserving surgery is an alternative where a one-off precipitant has been corrected.\"\n      }\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/05\/14\/paraphimosis-urologic-emergency\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2022\/05\/14\/paraphimosis-urologic-emergency\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Can paraphimosis wait until morning?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. It tightens by the hour because the swelling it causes worsens the constriction, so it does not settle by itself and reduction becomes harder the longer it is left. Reduction is a matter of hours, not days.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"What is the commonest cause of paraphimosis?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"A foreskin retracted for a urinary catheter or examination and not replaced afterwards. The patient is often elderly, confused or sedated and cannot report it, so carers should check that the foreskin is forward.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Can I push a paraphimosis back myself?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"One gentle attempt is reasonable. Repeated forceful attempts add swelling and make hospital reduction harder. Do not apply anything constricting, and attend immediately.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My son's foreskin will not pull back. Should I retract it?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. A childhood foreskin that does not retract is usually normal and separates in its own time. Forcing it can cause paraphimosis and scarring that creates a problem where none existed.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>A retracted foreskin that will not come forward tightens by the hour. It needs reducing the same day, not the next morning \u2014 and the commonest cause of all is a foreskin pulled back for a catheter and never put back.<\/p>","protected":false},"author":185281453,"featured_media":10075,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"A foreskin trapped behind the glans is a urological emergency needing reduction within hours. Causes, what to do while getting to hospital, and how to prevent it after a catheter.","jetpack_seo_html_title":"Paraphimosis: Emergency Treatment | Dr. Soarawee Bangkok","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1363],"tags":[1532,1710],"class_list":["post-5047","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mens-health","tag-men-health","tag-paraphimosis"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-1jp","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Paraphimosis.webp?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts\/5047","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/comments?post=5047"}],"version-history":[{"count":22,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts\/5047\/revisions"}],"predecessor-version":[{"id":11746,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts\/5047\/revisions\/11746"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/media\/10075"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/media?parent=5047"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/categories?post=5047"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/tags?post=5047"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}