Case study: emergent penis ring removal

[thelema13]

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 member 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 member 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!

[Esme12, ASN, BSN, RN]

just get a script for Viagra...sigh.

[motherof3sons]

Add this one to things we never thought we would see/hear about.....

[nurse2033, MSN, RN]

Nice case study, thanks! Did you try aspirating blood from the member? Was urology unable to come to the ER?

[PTKChic]

Wow, very interesting. This case has my husband shaking in his boots.

[WoundedBird]

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.

[whichone'spink, BSN, RN]

Biggest lesson for men: Don't put a ring on your member, FFS!

[meanmaryjean, DNP, RN]

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.

[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?

[LadyFree28, BSN, LPN, RN]

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

[thelema13]

Nice case study, thanks! Did you try aspirating blood from the member? 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.

[thelema13]

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.