Revision sheet

Acute paraphimosis: reduction and release

8 steps, each one the authored title and caption from the interactive animation, with the frame captured from that step. Read it before the case, or print it and work through the steps in order.

Teaching only, not for diagnosis or treatment decisions. The text on this sheet is the animation's own step copy, reproduced verbatim.

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UrOops3D · UroRef · © Nity G

  1. 01

    Assess the constriction

    Acute paraphimosis: reduction and release. Step 1: Assess the constriction. Captured frame from the interactive animation.
    • The prepuce has been retracted and its narrow ring is stuck behind the corona as a tight band.
    • In front of it the inner prepuce and the glans swell.
    • Glans colour, sensation and voiding are checked, and the catheter that was left in with the foreskin retracted is noted.
  2. 02

    Penile block

    Acute paraphimosis: reduction and release. Step 2: Penile block. Captured frame from the interactive animation.
    • A penile block at the base: the needle goes in at 2 and at 10 o'clock, beside the dorsal neurovascular bundle, and the block is given time to work.
    • Reduction is painful; an unanaesthetised attempt is often abandoned.
  3. 03

    Sustained compression

    Acute paraphimosis: reduction and release. Step 3: Sustained compression. Captured frame from the interactive animation.
    • The glans and the swollen collar are wrapped in a swab and squeezed steadily, for minutes rather than seconds.
    • The oedema is wrung out back past the band and the collar visibly shrinks.
  4. 04

    Manual reduction

    Acute paraphimosis: reduction and release. Step 4: Manual reduction. Captured frame from the interactive animation.
    • Both thumbs push the glans back through the band while the index and middle fingers of each hand, behind the band, draw it forward.
    • The band rides over the corona and the prepuce lies forward over the glans.
  5. 05

    When it will not pass: punctures

    Acute paraphimosis: reduction and release. Step 5: When it will not pass: punctures. Captured frame from the interactive animation.
    • If the band will not pass, the swollen collar in front of it is punctured many times with a fine needle, away from the dorsal midline.
    • Oedema fluid beads out under gentle pressure and the collar shrinks; reduction is tried again.
  6. 06

    Dorsal slit of the band

    Acute paraphimosis: reduction and release. Step 6: Dorsal slit of the band. Captured frame from the interactive animation.
    • Still stuck: under local anaesthetic a straight clamp crushes the band at 12 o'clock and it is divided along the crush, skin and band only, superficial to Buck's fascia and the dorsal bundle.
    • The band springs open and the prepuce comes forward.
  7. 07

    Reassess viability

    Acute paraphimosis: reduction and release. Step 7: Reassess viability. Captured frame from the interactive animation.
    • With the band off, the dusky glans pinks up.
    • Capillary return is checked by pressing the glans, and voiding and the shaft skin are reassessed.
    • A glans that stays dark needs a senior opinion now.
  8. 08

    Dressing and the plan

    Acute paraphimosis: reduction and release. Step 8: Dressing and the plan. Captured frame from the interactive animation.
    • A light dressing on the slit edges, and advice on returning the foreskin after washing and after any catheter care.
    • The patient is told to return for a circumcision once the swelling and the slit have settled.

Derived from ParaphimosisScene.tsx at build time: every step title and caption above is the authored ProcedureDef text, reproduced verbatim, and this page shares its readable-points renderer with the animation itself. 8 of 8 steps have a captured frame.

Text fingerprint d6f0f87607b3e96c. A caption edit without a re-capture fails the production check, so the sheet and the animation cannot drift apart silently.