51 year old male with a very large metal cock ring that was purchased a few sizes too small. He put it on and had a solid erection for 4+ hours PTA. No other medical history.
This is what we did:
1: Ice packs
2: Ice bath for penis and testicles
3: Copious surgi-gel and digital manipulation
4: IV neosynephrine, 10mg in 500cc NS wide open, did not affect BP more than 10 points systolic but had little effect on diminishing his erection.
5: Patient urinated x3, minimal size reduction
6: IVP toradol, morphine, etomidate, versed and brought out the ring cutter, then the ring cutter broke.... the ring was surgical stainless steel 8mm thick
7: A whole lot more surgi-gel and I sent a nurse home to grab his Dremel.
8: Used the Dremel on and off for 1.5 hours, allowing time to allow the metal ring to cool (iced surgi-gel helped here) We used tongue depressors as a barrier/guard in between the penis and ring.
9: Ring pried open with some monstrosity tool from the OR.
10: Patient took a cold shower for 30 minutes, then ended up going home with a urology consult, percocet and a lesson well learned....
He had the ring on and a solid erection for approximately 7 hours. He was a retired firefighter/EMT and was cracking jokes left and right. It was a very sensitive, delicate, dangerous situation.
What did you just learn???????? Buy a rubber ring, and invest in a Dremel for your ED!