The Indian Journal of Surgery, a Springer-Verlag title, has retracted a 2011 paper with a title only the Marquis de Sade would love: “Penile Strangulation by Metallic Rings.”
We know what you’re saying: Who knew penises could be strangulated? Well, it’s true.
The article, by a pair of authors from the Government Medical College, in Kota, Rajasthan, in India, reported on the case of a 35-year-old trucker who, let’s just say, had the unhappy habit of arriving too soon at his destinations. His solution was simple — if insane. From the abstract:
Two metallic rings were self introduced upto the base of penis, in order to prevent spontaneous ejaculation at night. There was marked oedema of penis distal to rings, and these rings were removed with an indigenous technique, non-operatively.
As the retraction notice states:
This article has been retracted due to copyright issues.
But that’s not quite right. It seems the authors simply republished their version of an earlier case report — which in our understanding is plagiarism, not a copyright violation.
The original paper seems to have appeared in 2005 in the Bombay Hospital Journal. The details of the case are awfully — and we mean awfully — similar (caution: this link will take you to a rather explicit image of the event):
A 35 year old man presented to M.B. hospital, Udaipur with extremely swollen penis. On examination two metallic rings were seen at the base of penis.
On taking history it was revealed that he was advised by his friend to pass metallic ring over base of penis, to obviate penile erection and auto-ejaculation at night. He was practicing this method successfully since one year. On examination, gross oedema on distal part of penis was present and two metal rings were applied on base of penis (Fig.1) which could not be taken out. Patient was shifted to emergency O.T. in an effort to remove metallic rings. Lidocaine jelly was applied over penis, given multiple puncture, compression on penis was applied by hand and thin streams of fluid came out from multiple puncture sites but with all these we were unable to remove the rings and we did not get the suitable instrument to cut the rings safely. Finally an intravenous drip set tube was applied circumferentially, starting from tip of the penis to its base in order to have an even compression as a tourniquet (Fig. 2). The compression was maintained for 4 minutes and this procedure was repeated for five times. (In between the tourniquet application the penile compression was maintained by squeezing the penis with palm). This manoeuver reduced penile oedema dramatically and metallic rings could be retrieved manually over lubricated jelly. The whole procedure took around 50 minutes. The two rings were of 3.5 cm x 2.5 cm x 2 cm and 3 cm x 2 cm x 1.5 cm external diameter, internal diameter and width respectively (Fig. 3).
So, THAT’S what an “indigenous technique” means!
Fortunately for the patient:
There was no damage to penis at strangulation site as well as on distal part. Penis was cleaned with povidone-iodine solution, an antibiotic ointment was applied and dressed with vaseline gauge and light pressure bandage applied.
Patient remained cooperative during procedure. Before starting the procedure patient was pre-medicated with inj atropine 0.6 mg, midazolam 5 mg and tramadol HCl 100 mg intravenously with a patency iv drip and 2% lidocaine jelly was applied over penis. Antibiotics and Tetanus prophylaxis was also given. Psychoanalysis later revealed no abnormality. …
The method described above is highly effective, cost saving, complication free and can be done by every practitioner.
Indeed. But the same case reported can’t be published by every practitioner.
(If, by the way, you are offended by our headline, please contact Seth Borenstein, who suggested it in Helsinki, where he and Ivan are attending the World Conference of Science Journalists.)
I now have the answer to a question that has puzzled me for years: “Are there rubber bands in India?” And am I a bad person for considering the “indigenous technique” utilized to apply the rings in the first place? With an inner ring diameter of 2 cm one can only hope that 2% lidocaine jelly was nearby. And necessary.
Yes, lidocaine jelly (4% for urologic use) is a very useful tool. The lidocaine is rapidly absorbed because the skin of the penis is so thin.
Clearly you enjoyed reporting on this up-and-coming research (sorry) too much. While the original authors stated “Psychoanalysis later revealed no abnormality,” one wonders about those who thought up this ‘indigenous practice.’
A headline worthy of the Daily Show.
Amazing.
In fact, about ten years ago a man presented to my office late one evening with a ring trapped at the base of his penis, which was so swollen the ring could not be seen. I immediately ordered the application of a blood drawing tourniquet (a band of soft latex about one inch wide) around the penis, starting at the tip and proceeding proximally. This procedure was effective enough that a ring-cutting tool (borrowed from the hospital across the street) could be introduced to saw through the ring and allow it to be removed. I don’t doubt that if we had continued the procedure, we could eventually have been able to remove the ring without cutting.
The moment the ring was removed, the man jumped down from the table, pulled up his pants, and ran from the clinic. Since it was an emergency, the nurse had neglected to obtain the man’s name or insurance information.
True story. Not on my blog.
The subject was not trying to prevent premature ejaculation: he was trying to “obviate penile erection and auto-ejaculation” (it is an Indian thing: https://en.wikipedia.org/wiki/Dhat_syndrome)
Reblogged this on In the Dark and commented:
Here’s an interesting development from the inestimable blog Retraction Watch, which I thought I should present on my own organ. A paper on “Penile Strangulation by Metallic Rings” has been withdrawn from publication. Pity, because the authors probably went through lots of hoops to get it past the editor…
In my part of the world, when I was young in the 1960s, ladies of the night were often called, “Old brass” as a slang term. The reason was simple; They always carried a brass ring to prevent their customer from ejaculating. I have not heard the expression for a very long time now.