A drunk man fell asleep with nine metal rings strangling his genitalia, doctors have revealed in an eye-watering case.
Firefighters were needed to cut through the stainless steel with an electrical saw, in order to save his penis and scrotum.
The 44-year-old, from Australia, used the heavy duty steel rings in the hope it would help him stay erect.
He then fell asleep after having sex and woke up three hours later in significant pain to find the rings still on his now-swollen genitals.
Medics tried to remove the metal rings, which were just 1cm (0.4 inches) in diameter, with ring and bolt cutters but were unsuccessful.
They then enlisted the help of the fire brigade, who used an ‘industrial style electric circular saw’ to cut the rings off while the man was under general anaesthetic.
Doctors from Gold Coast University Hospital in Queensland said the man was in a lot of pain and distress when he arrived at the emergency department.
An examination showed his penis and scrotum were significantly swollen, tender and bruised, leading medics to give him an IV of opioid pain relief, according to the article published in Urology Case Reports.
During surgery to remove the rings, a tongue depressor and gauze were used as a protective barrier between the penis and saw.
The rings were also sterilised with cool saline solution to prevent a thermal injury from the power tool.
After all nine rings had been successfully removed, doctors performed a cystoscopy – a procedure to look inside the bladder using a thin camera.
The test found the patient’s urethra was irritated and swollen so a catheter was fitted in place for one week.
He did not need any further surgery but reported minor erectile dysfunction over the two months that followed.
The patient told medics he hadn’t taken any drugs before the incident.
Urologists reporting on the case said penile strangulation is rare and, because of that, can be a challenging medical emergency.
The authors wrote that there is no typical standard of care protocol for how to deal with penile strangulation and that emergency departments often lack the equipment or knowledge of the tools needed to cut them.
Penis strangulation over a prolonged time can cause blood flow to be cut off and obstruct the drainage of fluids, they said.
If it is not treated, it can lead to irreversible damage to the penis, which, in severe cases, needs to be amputated, the report states.
Sexual gratification, non-medical erectile dysfunction treatment and psychiatric disorders were listed as the motivations for using foreign objects on the penis.
As sex toys and erectile dysfunction medicine has become more easily accessible, the authors expect cases of penis strangulation to fall.