Paraphimosis in Circumcised Old Man

Abstract

Introduction: Paraphimosis is an emergency uncommon condition in which penile foreskin retracted to proximal and cannot be returned to its normal anatomic position.This condition occurs when the uncircumcised or partial circumcised male penis retracted for an extended period of time. In Indonesia, many men had been circumcised in the past not by doctor nor nurse, but traditional physician. They performed partial circumcision, so there was still foreskin covers part of glans penis that can cause paraphimosis. Method: We report one case, partial circumcised 60 years old man, came to Namira Islamic Hospital with complained swelling and pain on his penis since a night before. Before that, he pulled his penile foreskin backward. Then the foreskin made constriction band of tissue on the middle of his penile body. He went to nearby clinic and then referred to Namira Islamic hospital, East Lombok, and diagnosed as paraphimosis. We performed emergency surgery later. Results: We found constriction band of tissue on his middle part of his penile body. Distal part of constriction ring became swelling, and skin color became dark purple. Then we performed dorsal slit procedure continued with circumcision. After procedure, penis color became normal. Discussion: Paraphimosis most often happens in boys and older man. It is still can happen on partial circumcised man, because there is foreskin extent, which could become risk factor of paraphimosis. Treatment of paraphimosis is dorsal slit procedure with or without circumcision.