A case report of a man with mental health problems whose penis got stuck inside a plastic bottle for two months continues to show just how little support people struggling with mental health receive – doubly so when that need overlaps with sexual health.
The person in the case described in the International Journal of Surgery Case Reports is 45 years old and had a history of severe depression, as well as suicide attempts. The neck of the bottle was stuck on his penis for two months when the patient was taken to the hospital. The authors of the paper wrote that "Since he was mentally ill, he did not reveal the incident with his family members." By the time he got help, the penis had developed edema – swelling due to trapped fluid – as well as growths.
“Penile strangulation which is common in people with mental disorders should be considered as a surgical emergency as it can present with devastating complications. No specific methods and tools have been recommended for the removal of those objects,” the surgical team wrote in the case report. “The shame felt by patient is the root cause for late surgical consultation and are prone to develop complications. Simple instruments can be used for the intervention provided good surgical skills are demonstrated.”
There have been nearly 60 cases of penis strangulation reported in the literature since the first one in 1755. The various approaches taken vary, with some people employing the use of non-metallic objects – ranging from the plastic bottle in this case to adhesive tape and hair – to metallic objects like keyrings.
The employment of such objects is to prolong the duration of the erection or in autoerotic games. It is safer to use a cock ring of the appropriate size, instead of homemade devices. The team stresses that the variable nature of what patients use in the cases of penile strangulation requires the surgeon to be adaptable in using tools that might be unconventional in a medical setting. In this case, they use cable tire cutters to remove the bottle neck.
“Penile strangulation is common in psychiatric patients and warrants emergency management to preserve the organ function. Each case is managed exclusively according to its clinical findings and operative settings. Management depends on the type and size of the constricting object, available instruments, time after incarceration, degree of injury and experience of the surgeons. Different methods and tools can be used depending upon clinical scenarios,” the team concluded.
If you or someone you know is struggling with mental health, there are resources available. If you’re in the US, you can find a list of these on the National Institute of Mental Health website.