The 24-year-old Vietnamese must have had a steel nut severed from his penis with a drill after he got stuck during pleasure.
An unidentified patient was taken to a hospital in Ho Chi Minh City, where he told doctors that the clasp had been there for 10 hours.
He admitted to slipping a 2 cm (0.7 inch) thick hexagonal nut around the shaft to improve the masturbation experience.
The uncircumcised patient complained that his penis had become numb and he was unable to urinate.
His penis was so swollen that doctors couldn’t manually remove the makeshift pleasure ring and were forced to use a dental drill to cut it off.
Doctors found that a steel nut (left), which was 2.7 cm wide (1 inch) on the inside and 4.1 cm (1.6 inch) on the outside, “tightly trapped the shaft of the penis”, making it difficult to urinate and decreased sensation in the genitals. They finally removed the penis ring after a 45-minute procedure with a handheld electric dental drill (right) – which is usually used to make holes for fillings and remove plaque, but are also used to remove rings that get stuck on the fingers
Medics who reported on the incident in the Journal of Medical Case Reports said the man had been admitted to the emergency department of Cho Ray Hospital.
The metal nut got stuck 5 cm (1.9 inch) in his penis and “tightly trapped the shaft of his penis.”
Doctors noted that this made the patient difficult to urinate and decreased sensation in his genitals.
The man’s foreskin, which had been pulled back during masturbation, became so swollen that he could not return to its normal position and “choked” the tip of his penis.
The patient was connected to an intravenous drip and administered painkillers, antibiotics and sedatives.
WHAT IS CHAMFERING CURRENT?
Penile strangulation is a rare but often dangerous medical situation that occurs when an object or part of the body is blocking the blood supply to the penis.
In the worst cases, lack of blood flow can result in gangrene and tissue death – penile necrosis.
Medics have developed a rating system that indicates the degree of suffocation:
Grade 1: Swelling of the distal penis.
Class 2: Injury to the skin and constriction of the spongy body, but no signs of damage to the urethra. Distal penile swelling with decreased penile sensation.
Assessment 3: Injury to skin and urethra but no urethral fistula. Loss of distal penis sensation.
Grade 4: complete division of the spongy body leading to urethral fistula and cavernosal narrowing, with loss of distal penis sensation.
Assessment 5: gangrene, necrosis or complete amputation of the distal penis.
Due to the thickness of the device and the swelling of the man’s penis, the doctors were unable to remove it manually with a lubricant.
They said it was “impossible” to cut the nut off 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 dental clinic, medics decided to use a handheld electric dental drill – which is usually used to make holes for fillings and remove plaque, but also to remove rings that are stuck on the fingers.
They finally removed the penis ring after a 45-minute procedure.
Cutting metal produces heat as a by-product, so a man’s penis had to be sprayed with water to cool it down during the procedure.
Medics also placed a thin piece of plastic between the device and the penis to prevent damage to the shaft.
After an overnight stay in the hospital, the man was prescribed antibiotics and painkillers.
A follow-up visit a month later showed that his penis was back to normal and he was able to urinate and become erect, his doctors said.
Penile strangulation was first recorded in the medical literature in 1755 and has been rarely documented since then, with less than 100 official reports.
Penis rings reduce blood flow through the veins, which causes the penis and testicles to swell.
Doctors found that young men frequently use these devices while masturbating to increase sexual satisfaction as well as “sexual interest”.
According to their report, older men are more likely to use asphyxiation facilities to improve their performance in response to erectile dysfunction.
Medics noticed that the sexual act is sometimes also committed by mentally ill people.
Items including heavy metal rings and cones, pipes, plastic bottle necks, and hydraulic cuffs were reportedly used in cases of penis strangulation.
They warned that “urgent” medical attention was needed when rings on the penis got stuck as it could damage the blood vessels that 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 body tissue turns black and dies – and a tubulo-cutaneous fistula, which is an undesirable opening in the groin through which urine can leak.
In the most severe cases, penis amputation is required.
Each case of penile suffocation is treated individually, depending on the patient’s case. They found that most patients delay their treatment because of embarrassment.
Medics have concluded that thin non-metallic penis rings are “often easy to remove,” but metal objects “need to be removed safely” because standard surgical equipment “may not be able to cut them.”
Doctors said medics treating patients with penile strangulation must be “creative and resourceful” as not all treatments will work for all patients and saws and tongs have been used before.
The team noted that using a dentist’s drill was a “rare” method of removing penis strangling devices, but was “an excellent option” as it cuts “very smoothly in a short time without significant physical effort”.