ABSTRACT
In adults the cause of paraphimosis is mostly iatrogenic. It can occur as the result of urethral manipulations such as insertion of a Foley catheter or cystoscopy. Before such manipulations the preputium is retracted, to prepare the glans. All medical personnel should be aware of this risk, and remember to pull the preputium back to its normal position. If the prepuce is not returned to its normal position after manipulation and its opening is narrow, it may become trapped below the corona. This circumferential ring acts as a tourniquet, disturbing blood and lymphatic flow to and from the prepuce and the glans. The constriction sometimes can be so tight that, if left untreated, it can result in distal penile gangrene (Figure 4.2).
