A middle-aged man stuck his penis in the neck of a plastic bottle for two months in what was believed to be a masturbation game gone awry.
The unidentified 45-year-old from Nepal used the neck of a bottle to strangle his penis, a technique sometimes used for sexual pleasure.
When he finally went to A&E two months later, doctors had to use wire cutters to free his penis from the choke device.
Strangulation of the penis, which doctors say is often attempted as part of sexual “play,” can cut off the blood supply and even rot penile tissue if left on for too long.
Doctors from the Koirala Institute of Health Sciences said his penis had become extremely swollen due to lack of blood flow and the patient was on the verge of lasting damage.
But the man was unwilling to reveal why he did it and never returned for follow-up, so doctors don’t know how well he has recovered.
Writing in the International Journal of Surgery Case Reports, they said that “the shame felt by patients is the root cause of a late surgical visit”, which means they are “at risk of developing complications.”
The 45-year-old Nepalese man cut the cap off a plastic bottle to make a penis-strangling device, but wouldn’t admit why he did.
Doctors have said that the strangulation of the penis is a surgical emergency and is often seen in patients with mental disorders or who are trying to increase their sexual arousal.
People used different methods, such as duct tape, plastic bottles, rings, and key chains to perform the deed.
Doctors must urgently release the penis from the constricted object to preserve blood vessels and body tissue.
Doctors said, “Strangulation of the penis is often seen in psychiatric patients who seek to improve their sexual performance by prolonging the duration of erection or as part of autoerotic play.”
There is no recommended treatment as each case is different depending on the device used by the patient, how long it has been left in place, how much damage has been done and the equipment available at the hospital for it. withdraw, doctors said.
WHAT IS PENIAL STRANGULATION?
Strangulation of the penis 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, the lack of blood circulation can lead to gangrene and tissue death – penile necrosis.
Doctors have developed a scoring system to indicate the severity of the strangulation:
1st year: Edema of the distal penis.
2nd year: Skin damage and spongy body constriction, but no evidence of urethral damage. distal penile edema with decreased penile sensation.
3rd year: Damage to the skin and urethra but no urethral fistula. Loss of distal sensation of the penis.
Level 4: complete division of the spongy body leading to urethral fistula and constriction of the corpora cavernosa, with loss of distal penile sensations.
Level 5: gangrene, necrosis or complete amputation of the distal penis.
Early surgery is needed once
The man, who was severely depressed and kept the incident a secret from his family, visited A&E two months after putting his penis in the neck of the bottle, which he had cut from the rest of the bottle.
He had previously been diagnosed with severe depression and had attempted suicide several times.
Doctors failed to remove it with standard cutting equipment, so they used a cable wire cutter, which is not commonly used by doctors, to remove the neck of the bottle.
Doctors said the first case of penile strangulation was reported in 1755 and dozens of similar incidents have been reported since.
In an even more extreme case, two schizophrenic patients who attempted the act had their penis amputated, doctors have revealed.
Dr Jamin Brahmbhatt, urologist at Orlando Health Medical Group Urology, told MailOnline that cases of penile strangulation are very common and that he has seen two in his career.
He said: “The problem that occurs is that the device is placed on the penis and it cannot come off.
“Imagine your wedding ring unrolling easily, but then you have swelling in your hands and it becomes harder to get rid of.
“This is what happens in an acute environment around the penis.
“Everything around the penis limits the blow which then causes swelling – but if the swelling is too much and your body (or your hands) cannot reduce the swelling, you are ‘stuck’.
Dr Brahmbhatt said that in the two people he treated for penile strangulation, he used orthopedic saws and knives to remove the metal cock rings.
He said: “We literally had to use a saw and a cutter a few millimeters from the penis. It’s pretty intense.
“After the device is cut off, the penis usually returns to normal within a few weeks – the bruising and swelling may take a few weeks to go away.
“In the long run, we have to worry about penile scarring, abnormal curvature of the penis and loss of erections.”
Earlier this year, doctors at Marrakech University Hospital had to cut a metal ring from a man’s genitals after the homemade sex toy cut off his blood supply.
The unidentified man confessed to using the 1.6 inch (4 cm) diameter gold ring for hours after trying to “extend” his erection by masturbating.
In another case, an elderly dementia patient in Chicago strangled his own penis after wrapping it with rubber bands and leaving it on for three days.
The unidentified 81-year-old man had to undergo emergency surgery after the skin on the tip of his limb began to rot.
Yellow and purple spots began to appear on both the shaft and the base of his penis due to the lack of blood supply.