Paraphimosis in Dogs and Cats

1 Symptoms

Paraphimosis usually follows penile trauma with acute inflammatory edema that enlarges the penis and reduces tone of the retractor muscle. The penis head remains outside the prepuce; the constricted ring swells, shows diffuse edema, turns bluish, and is painfully sensitive, with possible abrasions, ulcers, and necrotic areas.

Over time the inflammation becomes chronic, with connective-tissue thickening; the swelling is then firmer, cooler, and painless. If caused by a tumor at the preputial opening, difficulty urinating and restlessness may appear.

In paralytic paraphimosis the lower part shows no obvious injury, temperature is normal or slightly low, the penis can be replaced but immediately protrudes again, and pain sensation is dulled. There may be loss of sensation around the perineum, hind limbs, and scrotum, with a relaxed anus and tail and even hind-limb incoordination.

2 Causes and Transmission

The condition is not contagious. It is caused by factors that prevent the penis from returning into the prepuce: post-traumatic inflammatory edema, inward folding of preputial skin, preputial sac eversion, penile-head tumors, or posthitis.

Neurologic or spinal causes can produce the paralytic form, with loss of sensation and muscle tone in the region.

3 Diagnosis

Diagnosis is clinical, based on the exposed, swollen penis and inability to retract it. The veterinarian evaluates whether the cause is inflammatory edema, a stricture, a tumor, or neurologic paralysis, and checks for tissue necrosis or bladder involvement.

4 Treatment

The underlying cause is addressed and the animal is prevented from licking the area. For recent cases caused by inflammatory edema, the area is cleansed with a mild antiseptic solution, a soothing or antibiotic ointment is applied, and the penis is gently replaced into the prepuce; an antibiotic preparation may be instilled into the sac for several days.

For stricture or tumor-related paraphimosis, the scar or mass is surgically removed before replacing the penis. Animals with progressive necrosis, extensive scarring, or ulcers are not suitable for breeding and, when necessary, may require partial penile amputation. A veterinarian directs all such treatment.

5 Prevention

Prevent penile trauma and keep the preputial area clean. Seek prompt care for any swelling or inability to retract the penis to avoid necrosis.

Use an Elizabethan collar to stop licking and self-trauma while the area heals.