Paraphimosis in elderly men

Paraphimosis occurs when the foreskin of the penis is retracted over the glans and cannot be replaced in its normal position. The tight ring of preputial skin constricts the distal penis causing vascular occlusion, much like a tourniquet. The condition is painful and, if not dealt with quickly, can lead to necrosis of the glans. Simple reduction of the prepuce can be achieved by compressing the edematous fluid out of the glans and repositioning the foreskin. Irreducible paraphimosis is treated by dorsal slit procedure and subsequent circumcision. We present two cases illustrating the treatment techniques and possible complications of paraphimosis in men.