Case study: emergent penis ring removal

  1. 14 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!
  2. Tags
    Visit  thelema13 profile page

    About thelema13

    thelema13 has '3' year(s) of experience and specializes in 'ED'. From 'Florida'; Joined Jun '11; Posts: 286; Likes: 361.

    18 Comments so far...

  3. Visit  Esme12 profile page
    4
    just get a script for Viagra...sigh.
    poppycat, sharpeimom, psu_213, and 1 other like this.
  4. Visit  motherof3sons profile page
    2
    Add this one to things we never thought we would see/hear about.....
    poppycat and psu_213 like this.
  5. Visit  nurse2033 profile page
    3
    Nice case study, thanks! Did you try aspirating blood from the penis? Was urology unable to come to the ER?
    sharpeimom, psu_213, and Esme12 like this.
  6. Visit  nae312213 profile page
    3
    Wow, very interesting. This case has my husband shaking in his boots.
    amoLucia, poppycat, and sharpeimom like this.
  7. Visit  WoundedBird profile page
    1
    This is bringing me back to a conversation I had with the guys that run a well respected piercing shop about having in-services for nurses and docs to learn how to remove body jewelry appropriately. Now the hamster in my mind has awaken (at 1am nonetheless) on possibly setting something up at my nursing school.
    B.C.nurse likes this.
  8. Visit  whichone'spink profile page
    0
    Biggest lesson for men: Don't put a ring on your penis, FFS!
  9. Visit  meanmaryjean profile page
    6
    A guy in our ED years ago had FOURTEEN metal key rings on his. We were forced to turf him to a tertiary care 20 min away, but not until AFTER our maintenance guy passed out after trying to use the ring cutter.
    nrsang97, poppycat, Here.I.Stand, and 3 others like this.
  10. Visit  mamagui profile page
    0
    Wait...I'm confused. Was this like a Prince-Albert style piercing with too small of a ring, or was it just a thick metal ring placed around the circumference while flaccid that could not be removed due to the erection?
  11. Visit  LadyFree28 profile page
    0
    Quote from mamagui
    Wait...I'm confused. Was this like a Prince-Albert style piercing with too small of a ring, or was it just a thick metal ring placed around the circumference while flaccid that could not be removed due to the erection?


    Unfortunately, he didn't get the memo about the rubber ones though...

    At least it wasn't a Cunningham Clamp malfunction
  12. Visit  thelema13 profile page
    0
    Quote from nurse2033
    Nice case study, thanks! Did you try aspirating blood from the penis? Was urology unable to come to the ER?
    No urology coverage for over a month. If the Dremel didn't work he was going to try either injecting neosynephrine at the source or aspirating some blood out. I have seen priaprism reversed on a 24 year old by urology after doing a local block with lidocaine/marcaine mix and aspirating with an 18g needle, but that was brutally scary.
  13. Visit  thelema13 profile page
    1
    Quote from mamagui
    Wait...I'm confused. Was this like a Prince-Albert style piercing with too small of a ring, or was it just a thick metal ring placed around the circumference while flaccid that could not be removed due to the erection?
    The latter.
    mamagui likes this.
  14. Visit  ChristineN profile page
    0
    Quote from thelema13

    No urology coverage for over a month. If the Dremel didn't work he was going to try either injecting neosynephrine at the source or aspirating some blood out. I have seen priaprism reversed on a 24 year old by urology after doing a local block with lidocaine/marcaine mix and aspirating with an 18g needle, but that was brutally scary.
    The idea of no urology is scary. I am surprised that you guys didn't transfer him elsewhere


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