Zipper accidents, fractures and more: Health experts' advice on men’s injuries 'down there'
What happens when the impact to a man's crown jewels is more searing than a zipper snag? Doctors tell CNA Lifestyle why these injuries should be tended to immediately. Warning: Graphic descriptions ahead.
If you remember that iconic bathroom scene in the 90s movie There’s Something About Mary, you’ll wince at the memory of Ben Stiller’s character, Ted, accidentally zippering up his “franks and beans”. It doesn’t matter whether you’re male or female. The zipping and screaming will forever draw empathetic and horrified gasps – and guffaws – from the audience.
It might surprise you to know that the scene, which is equal parts hilarity, embarrassment and medical mishap, wasn’t even made up by scriptwriters the Farrelly brothers. It was apparently based on an actual childhood event – their sister’s eighth-grade friend, to be exact.
She had a group of friends over and when one of the kids didn’t come out of the bathroom for a long time, their father, who was a doctor, went in to check on him. Years later, we finally see what Dr Farrelly witnessed in that bathroom.
DOWN-THERE INJURIES THAT REALLY HAPPENED
In real life, there is no shortage of There’s Something About Mary-type incidents that have also brought men much pain and embarrassment. “The most memorable penile injury I have seen is a patient, who had woken up with a morning erection,” said consultant urologist Dr Daniel Yong from Tan Tock Seng Hospital.
Nothing unusual there except he had a slip in the bathroom and fell. What happened next was a serendipitous, direct and excruciating meeting of his engorged member and the toilet bowl.
“He experienced immediate pain and heard a snap,” recounted Dr Yong of the patient’s penile fracture. “He put up with the pain for three days and only saw us when he could not tolerate it any further. By then, he had large bruises spreading to his entire scrotum.”
Penile strangulation is another injury seen among men here. The memorable cases that urologist Dr Chong Kian Tai from PanAsia Surgery has seen involved two separate patients: One had difficulty removing a metal penis ring; the other, a 1.5-litre plastic bottle.
In the first patient, the strangulation caused by the ring had caused his appendage to swell, making attempts to remove the ring by the hospital’s A&E department and subsequently, the Singapore Civil Defence Force, unsuccessful.
“The metal ring could not be dislodged even after aspirating 50ml of blood from the corpora cavernosum (the two spongy columns that fill with blood to create an erection),” wrote Dr Chong in his 2009 report in the Singapore Medical Journal. Eventually, the team managed to cut up the ring using an orthopaedic surgeon’s specialised cutter.
As for the elderly patient who had a mishap with a plastic bottle, the man managed to trim off most of the bottle two to three days after it was lodged. But he could not remove the neck of the bottle, even with copious amounts of soap – and lived with the plastic strangulating his penis for more than a week before seeking medical help, according to Dr Chong.
The constriction also meant that he could not empty his bladder properly. Upon removing the plastic piece, a total of 1 litre of urine was drained from the elderly patient. However, he later developed complications and died of ischaemic heart disease.
TEARS, FRACTURES AND DISLOCATIONS
While the abovementioned injuries sound extreme, doctors say injuries to men's privates are commonplace. “In real life, such injuries occur usually from the rushed zipping of pants,” said Dr Colin Teo, a urologist with Gleneagles Hospital. In fact, it is one of the top penile injuries he sees, he said.
Embarrassment aside, zipper injuries are no joke. “This can result in scrotal skin tears,” said Dr Yong. “Medical attention should be sought to stop the bleeding and suture the skin, if required.”
Other down-there injuries are often caused by sex, sports or self, according to the urologists that CNA Lifestyle spoke to. But regardless of the cause of injury, see a doctor immediately because pain, bruising, swelling or bleeding is a big red flag. Here’s a look at the other forms of injuries and why you should get medical help, pronto:
- Penile fracture
Perhaps the most common penile injury in men is a penile fracture. But wait, what is actually broken when there is no bone in a, well, boner?
“Although the penis is not actually a bone, the ‘fracture’ is a result of a tear in the tunica albuginea – a sheath within the penis that plays a part in maintaining erections,” said Dr Yong, who added that the main cause of the trauma is typically associated with vigorous sex and the partner-on-top position.
“The injury usually involves the penis slipping out and getting pushed up against the partner’s perineum.” It can also be caused by trauma during masturbation, he said.
You’ll know that something is wrong when you hear a “pop” and pain in the penis kicks in, said Dr Teo. “There’ll be a sudden softening and loss of erection with large swelling and bruising of the penis.”
The worst thing you can do is lie in bed and wait for the pain to subside. “It needs emergency surgery to close the bleeding area to reduce future scarring and deformities in the penis,” said Dr Chong. “If you delay treatment, it can cause internal scarring, erectile dysfunction, Peyronie's disease and deformity in the penis.”
- Testicular dislocation
After subjecting your testicles to blunt force trauma (getting involved in a motorcycle or bicycle accident, or getting hit or kicked in the nuts), there is a chance you might suffer from a testicular dislocation.
It is when a testis is dislocated from its normal position in the scrotum, said Dr Teo. You’ll know that something is wrong not just because of the excruciating pain and swelling – but because you can’t feel your testis in the affected side of the scrotum, he said.
“If the pain subsides quite quickly, no external wound is noted and the testes feel soft, this may be managed conservatively,” said Dr Yong. This could simply mean massaging and coaxing the displaced testis back to its original position, added Dr Teo. “If the testes are not ruptured, no further treatment is needed.”
To assess testicular ruptures, an ultrasound should be performed, said Dr Yong. It will also pick up other injuries such as haematomas – all of which (testicular ruptures included) require surgical repair. And sometimes, you need surgery to fix the testis back into the scrotum, he said. “The delay in treatment usually results in loss of function of that affected testis.”
Surgery may also be needed to bring the testis back if the incident happened long ago, said Dr Chong, so it is always a good move to inform the doctor if you cannot feel your testes after an accident.
You aren’t likely to require medical care if the scrotal pain and swelling subside, said Dr Chong. However, see a doctor if they persist. “There may be testicular rupture or internal bleeding, which may need immediate emergency surgery.”