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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Have phimosis. Following stretching excercises. Pain in hands and toes are due to paraphimosis. Should I be worried?

Answered by
Dr.
Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 3342 Questions

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Posted on Mon, 11 Nov 2013 in Men's Health
Question: Sir/Mam, I am quite sure I have phimosis as i cannot retract my foreskin back comfortably, it is tight. I am following few stretching exercises like stretching the opening of foreskin, pulling it back backwards as much as possible while bathing and soaping glans for cleaning, pulling it back backwards while peeing,etc. for last 2-3 days and i can see a slight improvement. But my main question is that around 3 days back when i was forcefully trying to retract the foreskin it got stuck behind glans. And after 15-20 minutes, i fixed it in its normal position by pushing it back forward. Is there still any danger? Because i am feeling very nominal pain in my hands and toes. but there is no problem in penis and while peeing also no problem at all. So pains in my hands and toes are due to that paraphimosis incident or it is altogether different thing? I went to Normal Doctor nearby home and told him about pain in hands and toes and not paraohimosis incident. He touched and examined my Hands, Toes, Heartbeats and then gave me some medicines and pain reliever for 5 days. Is it Okay?
doctor
Answered by Dr. Prasad 31 minutes later
Brief Answer:
The situation seems normal...

Detailed Answer:
Hi,

Yes, you seem to be facing difficulty retracting foreskin and as you have heard right, this condition is termed phimosis. However in most men phimosis improves gradually as you become more active sexually. Very rarely when you develop pain or problems during intercourse we actually need to treat this phimosis.

I had to give you the first information because, retracting foreskin can lead to paraphimosis which in turn can become a medical emergency. The tight constriction are known to cause irreversible neurovascular damage; so I refrain you from any forceful manipulation.

As far as your last episode is concerned, some men do experience warmth and painful feet and palms as the nerves on glans and foreskin is stimulated. Perhaps the tight band may have sensitized the nerves leading to painful feet and hands. If you are able to move the foreskin and if there is no tight band now, you need not be bothered. This situation seems to be in control now. No medications necessary...

However refrain from forcing the foreskin back or retracting it. You can plan its treatment if you face problems during intercourse.

Hope this helps. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 18 minutes later
Thank you sir for the Reply. Yes, I have phimosis and while trying to retract, my foreskin was trapped behind glans end (ring) for about 20 minutes but then I manually fixed it back to its normal position. I am able to pee comfortably, musterbated once today morning, also there is no sign of any damage or unusual thing in penis. My only concern is unusual nominal pain in hands and toes/feets from last 2 days. Readed somewhere that Paraphimosis can cause Gangrene and Gangrene starts with fingers and toes only thats why I am hell worried. Can such a short duration paraphimosis which was fixed within half an hour result in Gangrene? What should I do if this is the case? Am I worrying unnecessarily? Please help sir
doctor
Answered by Dr. Prasad 9 minutes later
Brief Answer:
No, this pain isn't related to paraphimosis...

Detailed Answer:
Hi,

Yes, the tight band of paraphimosis causes vascular obstruction which leads to gangrene if it's not corrected. However gangrene that follows is limited to penile structure.

Gangrenous changes of feet and hands are caused by individual obstruction of blood vessels supplying hands and feet. Naturally, a tight band on the penis wouldn't obstruct arteries of feet and hands. Therefore be rest assured the pain in hands and toes is not due to gangrene.

Since you have been evaluated already by a physician, I would advice you to be rest assured. You should be feeling better in the next 2-3 days with the pain medicine. If it doesn't improve further testing - hemogram, ESR, blood sugar, vitamin B12, Vitamin D and TSH tests are in order.

Hope I clarified your doubts. Feel free to write back if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 26 minutes later
Thank you sir. Very much reliefed now as I was very tensed. I hope this pain reduces in next few days. A final question I would like to ask is regarding non surgical treatment of Phimosis. I haven't done sex yet so can't say I will face problem during Intercourse or not. I've heard that Circumcision should be kept as a last option for curing this and we should first try for stretching techniques. Does Stretching techniques really cure Phimosis? If Yes, Then how much time it can take?
Thanks.
doctor
Answered by Dr. Prasad 11 minutes later
Brief Answer:
Circumcision is your choice...

Detailed Answer:
Hi,

Phimosis becomes a concern only if it affects urination and if affects sexual activity. If you have no problems with both these activities, technically phimosis doesn't need to be treated. Yes, off course there are odd exceptions to it.

Therefore I do not recommend you try anything now until you become active sexually.

You can try conservative treatments like using artificial lubricants during intercourse if it hurts you. You can choose to undergo circumcision if the pain persistently affects sexual life.

The above set of action is what I recommend all my patients with phimosis. You can opt for circumcision before sexual activity if you are too conscious about future sexual life.

Hope this helps. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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