Penile Strangulation by a Metallic Ring in a Male Adult: New Fangled Idea in Time of Agony

Entrapment of penile ring during self-sexual activity is a rare and bizarre presentation in urology emergency department with imminent risk of distal penile loss and gangrene which may require to penile amputation due to underlying vascular injury. Aside enhancing sexual performance, rings may also be inserted for autoerotic, masturbation or due to psychiatric disturbances or depression. Mental health evaluation remains vital to forestall future reoccurrence of such bizarre tendency. Urgent retrieval of the offending device is vital to preserve sexual function. We report our experience with a 28 year old male patient who had penile ring entrapment and acute urinary retention requiring anesthesia to ease manipulation with advanced orthopedic device (wire cutter). Due to consequent acute urinary retention, we immediately inserted a size 16 french two way catheter for drainage of the urine and forestall progressive retention of urine. We drained 700 ml while on table which further confirms acute urinary retention which probably must have added to the excruciating pain. Subsequent interaction with the patient was uneventful and he was counseled to avoid such self-sexual practice in future. Mental health evaluation by the mental health physicians was also uneventful.