A 24-year-old Vietnamese man needed a 2 cm thick steel nut from his “strangled” penis.


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A 24-year-old Vietnamese man had to have a steel nut cut from his penis with a drill after being hooked while enjoying it.

The unidentified patient went to Ho Chi Minh City Hospital where he told doctors that the fixator had been stuck there for 10 hours.

He admitted that he had pushed the 2 cm (0.7 inch) thick hexagonal nut around her shaft to enhance her masturbation experience.

The uncircumcised patient complained that his penis had become numb and that he could not urinate.

His penis was so swollen that doctors could not remove the impromptu pleasure ring with his hand and were forced to use a dental drill to cut it.

Finally, they removed the ring from the penis after a 45-minute procedure using an electric hand-held dental drill (pictured), which is usually used to make holes for fillings and remove plaque, but also they use to remove the rings that stick to the fingers.

Doctors said the steel nut (left), which was 2.7 cm wide (1 inch) inside and 4.1 cm wide (1.6 inches) outside, “he was squeezing the shaft of his penis hard,” causing difficulty urinating and decreased sensation in his genitals. . Finally, they removed the ring from the penis after a 45-minute procedure using an electric hand drill (right), which are usually used to make holes for fillings and remove plaque, but are also used to remove the rings that stick to your fingers.

Doctors, who detailed the incident in the Journal of Medical Case Reports, said the man was admitted to the emergency department of Cho Ray Hospital.

The metal nut had been attached 5 cm (1.9 inches) from her penis and was “firmly gripping the shaft of his penis.”

Doctors noted that it was causing the patient difficulty urinating and decreased sensation in the genitals.

The man’s foreskin, which was pulled back during masturbation, had become so swollen that he could not return to his normal position and was “strangling” the tip of his penis.

The patient was connected to an intravenous drip and was given painkillers, antibiotics and sedatives.


Penile strangulation is a rare but often dangerous medical emergency that occurs when an object or part of the body blocks the blood supply to the penis.

In the worst case, lack of blood flow can cause gangrene and tissue death: penile necrosis.

Doctors have devised a classification system to indicate the severity of the strangulation:

Grade 1: Edema of the distal penis.

Grade 2: Skin injury and spongy body constriction, but no evidence of urethral injury. Distal penile edema with decreased penile sensation.

Grade 3: Injury to the skin and urethra but without urethral fistula. Loss of sensations distal to the penis.

Grade 4t: complete division of the spongy body leading to urethral fistula and constriction of the corpora cavernosa, with loss of distal sensations of the penis.

Grade 5: gangrene, necrosis or complete amputation of the distal penis.

Due to the thickness of the device and the swollen penis of the man, doctors were unable to remove it manually with lubricant.

And they said it was “impossible” to cut the female with screw cutters because there was no space between the strangulation object and the skin of the man’s penis.

After consulting with colleagues at the hospital’s dental clinic, the doctors decided to use an electric hand-held dental drill, which is usually used to make holes for fillings and remove plaque, but is also used to remove the rings that stick to your fingers.

Finally, they removed the ring from the penis after a 45 minute procedure.

The metal cut creates heat as a by-product, so the man’s penis had to be sprayed with water to cool it during the procedure.

Doctors also placed a thin piece of plastic between the device and the penis to prevent the shaft from being injured.

After spending the night in hospital, the man was prescribed antibiotics and painkillers.

A follow-up appointment a month later showed that his penis had returned to normal and that he could urinate and get erect, his doctors said.

Penile strangulation was first recorded in the medical literature in 1755 and has rarely been documented since, with less than 100 official reports.

Penile rings reduce blood flow through the veins, causing the penis and testicles to swell.

Doctors said young men often use the devices as part of masturbation to increase sexual gratification as well as “sexual curiosity.”

According to his report, older men are more likely to use strangulation objects to increase their performance in response to erectile dysfunction.

Doctors noted that sexual intercourse is also sometimes performed by people with mental illness.

It has been reported that objects such as heavy metal rings and cones, pipes, plastic bottle necks and plumbing cuffs have been used.

They warned that “urgent” medical attention is needed when the penis rings become attached because they can cause damage to the blood vessels, which carry blood between the organs and the heart.

In cases where the penis is strangled for more than 30 minutes, there is also a risk of sepsis, gangrene – when the body tissue turns black and dies – and urethrocutaneous fistula, which is an unwanted opening in the groin for where urine can come out.

Penis amputation is necessary in the most severe cases.

Each case of penis strangulation is managed individually, depending on the patient’s case. They observed that most patients delay seeking treatment due to embarrassment.

Doctors said non-metallic thin penis rings are “often easy to remove”, but metal objects are “difficult to remove safely” because standard surgical equipment “may not be can cut “.

Doctors treating patients with penis strangulation need to be “creative and ingenious” because not all treatments will work for all patients, with saws and pliers used previously, doctors said.

The team noted that using a dental drill is a “rare” method of removing penis strangulation devices, but it was an “excellent option” as it cuts very gently in a short time. without significant physical exertion “.

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