sex in the ER, the sequel

Shortly after posting "sex in the ER", my saintly wife and I were watching a sporting event on the TV. The inevitable ad for a medication to treat ED (erectile dysfunction or failure to launch) appeared. The warning that if you developed an erection that lasted more than 4 hours you should not celebrate, but should seek immediate medical attention. If you are naive enough to call the prescribing physician, you would be told to go to the ER. Thus we have sex in the ER, the sequel, or sex, the final frontier.

Priapism is a painful and persistent erection. If untreated, priapism can cause permanent damage to the erectile mechanism. The treatment of priapism involves needles being stuck into the penis; enough said.

Other misadventures can occur to the penis by intentional or unintenional acts. Penis rings are used to maintain or augment the male erection. Unfortunately, the swelling they cause may preclude their removal.

A pleasant, schizophrenic patient of mine had polydipsia. Whether he drank large amounts of water because of the dry mouth that antipsychotic medication can cause, or just because he was a little off, his polydipsia led to polyuria. He had to urinate frequently. Being an outdoor type of guy, finding places to urinate was a problem. His unique solution was to place a steel key ring around the base of his penis. When the swelling became too painful to bear he showed up in the ER with a rather large problem. Ring cutters are designed to cut through relatively soft gold, not hardened steel. I was eventually able to remove the offending ring, much to my patient's relief.

The penis is also susceptible to being fractured while in the erect state. The three compartments of the shaft of the penis have fairly strong walls. When enough force is exerted during certain sexual positions, these walls can break causing a penile fracture.

Rashes and burns from lotions, potions and candle wax are also conditions that can effect the poor penis. I would be remiss if I didn't mention the infamous Amazonian catfish. This tiny fish is attracted to urea. If voiding urine while standing waist deep in the Amazon is on your travel itinerary, be forewarned. This unique catfish will propel itself through the penile meatus and using the spines in its fins, will become lodged in the urethra. OUCH!

Women are not immune to problems with their sexual apparatus. Lost objects (most commonly a condom), injuries from overzealous partners or sex toys, and the same lotions potions and candle wax, may lead to a visit to the ER's pelvic pavilion. Every ER has at least one room or bed designated for examination of a woman's pelvic organs. Specula, swabs, ring forceps, fiberoptic lights are used to diagnose and treat those problems unique to the female anatomy.

The take home lessons are be smart, be careful, be prepared, have fun but don't urinate while swimming in the Amazon.