Paraphimosis (paraphimosis; from the Greek. para - and about phymosis - compression; popular name - "stranglehold", "Spanish collar") - infringement of the penis head of domestic leaf foreskin, usually occurring during forcible resettlement her by the head (Fig. 1). In congenital narrowness prepucialna bag (see Phimosis) free exposure of the head, as a rule, is impossible. At a moderate same narrow it it is usually with some violence is possible contrary to the reduction head in prepucialna bag is difficult or impossible. The same happens when shortened and malolactic bridle, when the head of the penis for discharge of the foreskin up deviates downwards, and circular groove (the word " Collum " glandis) is deeper. When the complete inability of the reverse assignment of the foreskin over the head down last infringed prepucialna ring. Therefore developing the disorder of blood circulation in the head and in the inner leaf of the foreskin and they are sometimes partial necrosis; occasionally there gangrene.
Development of paraphimosis promotes inflammation of the glans penis and foreskin (see Balanitis, balanopostit). Due to an inflammatory swelling of the inner leaf foreskin when screwing his head last may also be infringed the foreskin. The cause of paraphimosis may be moderately expressed underwater vents prepucialna bag result in scarring ulcerations on the edges of the foreskin, arising out of gonorrhea discharge or soft chancre of prepuce. In some cases, individuals with narrow prepucialna bag and short foreskin paraphimosis arises from sexual intercourse or Masturbation, when the outflow of blood from the erect head delayed.
Diagnosis of P. easy on the basis of this disease patterns.
When paraphimosis urgent need to provide medical care. In the first hours of infringement, you can try to straighten penis head in prepucialna bag, for which the head of the penis and the inside piece of the foreskin grease sterile vaseline oil. Then, clasping member of the fingers of the left hand, right hand gently squeeze the head and pushing edema fluid under infringe prepucialna ring, gradually set under the head (Fig. 2). After the reduction the penis to reduce swelling podbitaya up. The reduction is very painful and it should be done after the pre-injection 1% solution of morphine or under circular local anesthesia of 0.25 - 0.5% solution novokaina mixed with 1 million UNITS of penicillin to the root of the penis. In the case of failure, reset immediately or later should be done under local anesthesia dissection infringe rings over summed up under it globulinam probe. In order to avoid relapse can be made excision the stranglehold - from infringing ring excised the cuff width of 1,5-2 see the edges of the incision is stitched with catgut.
Prevention of paraphimosis is hygienic content prepucialna bag and operative elimination of phimosis dissection or circular excision of the prepuce.

Fig. 1. Infringement of the penis head is wrapped her prepucialna bag
Fig. 2. Resetting the head of the penis in prepucialna bag when paraphimosis.

Paraphimosis (the noose or the so-called Spanish collar) arises from enforced delay narrowed foreskin over the head of the penis; comes with infringement of the penis back of the head, oedema and its inner leaf of the foreskin (Fig. 69). If the infringement is not timely resolved, comes gangrene disadvantaged ring foreskin, and sometimes head.
Paraphimosis is more likely to occur WB time of sexual intercourse or Masturbation.
In early detection and in the absence of necrosis infringe rings you can try gently put the head of the penis in prepucialna bag under essential skill. The pressure of the big fingers of both hands on the head of the penis slowly pushed it deep down, pull at her foreskin. This technique is valid if the correction is possible easily, otherwise, you should immediately cut infringe the ring, and put the crown. After the disappearance of the inflammatory reaction is circumcisio.