Provexam Different situations of the sheath include: phimosis, when the skin will no longer retract over the top of the male organ; and paraphimosis, while the sheath is stuck inside the retracted position causing swelling and ache. Q: what reasons a painful tumescence? A: known as priapism, some men enjoy painful and often extended tumescence no matter no physiological stimulation. Meaning they don’t need to have members of the family for the time being, but for some motive the male organ didn’t get the memo.