Ready to get grossed out? This medical education case just arrived in my email:
A 35-year-old man presents to the emergency department (ED) with complaints of acute-onset penile pain and swelling that started while in the act of sexual intercourse with his female partner 36 hours before presentation. During intercourse, he missed the vaginal introitus and hit the perineum with some force on attempting to re-enter the vagina with the penis while performing thrusting movements. His partner recalls hearing a cracking sound. He experienced instant penile pain, immediate loss of erection, and almost instantaneous swelling of the penis. About half an hour later he noticed blood at the urethral meatus. He presented to the ED 36 hours after the injury, by which time his entire penis is bruised, with progressive swelling. He has been unable to urinate since the injury; every time he has tried, blood oozes from his urethral meatus. As a result, he is also experiencing great discomfort from urinary retention. In the period before presentation, he applied ice packs and lay in a tub with warm water in an attempt to relieve the symptoms. The patient was reluctant to present for medical care and waited before seeking medical attention in the hope that his symptoms would improve.
The diagnosis: penis fracture requiring urgent surgical exploration and repair. Nasty! I didn't even show you the pictures. You can thank or curse me now or later.
is not that uncommon. Its also the leading KNOWN cause of Peyronie's Disease. Acute Penis Trauma. Would be nice to know the patients status post 200 days to see if he is symptomatic.
Reagan is correct. It turns out that the human penis is pretty flexible, which was discovered during research done with couples doing it in an MRI machine--oh those Dutch scientists (http://www.bmj.com/content/319/7225/1596.full)! But it has its limits, especially if it slips out of the hole and gets rammed against another part of the body. It seems that most cases are minor, but I would not want to be this guy.
The provider was riding him cowgirl style and jumping up and down fairly aggressively tying to make him cum- then she missed and came down on his dick with her full weight.
He said it hurt like a son of a bitch, but he wasn't injured to the extent of the guy in the medical case you posted. He never went to the doctor because he started showing improvement in a couple days and was pretty much OK in a week. But he didn't see any ladies for another couple weeks just to give it a rest.
Good idea to bring up the subject. I have seen this happen to quite a few people when I used to work at an ER. That is why I traditionally stick only to mish, doggie where I have control and refrain from acrobatics like Cowgirl, Reverse cowgirl etc where I do not have control over the thrusts. Again this is because of what I have seen and I am just paranoid about penile fracture.
One more thing to remember is that the penis is usually never damaged by trauma when flaccid, only during erection. With more guys taking ED drugs, and sustaining hard rigid penis like they probably never had before, the frequency of penile fracture is increasing, even though fortunately it is still rare.
God forbid if it happens to anyone, just remember to go to ER asap as penile fractures need to be explored in 4hrs, max 8hrs. If explored and repaired right away, the chance of future Erectile dysfunction is very less.
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