An American man may never be able to use his penis again after his partner accidentally sprayed expanding foam up his urethra in a sex act gone wrong.
The 45-year-old patient had to have a new opening cut between his scrotum and his anus to urinate when the foam hardened and became 'anchored' in his penis.
Medics who treated him said he will only qualify for reconstructive surgery if he passes a psychiatric evaluation.
The unidentified man was struggling with impotence, and had been inserting various objects into the opening of his penis during sex to stay erect.
But things went horribly wrong during one of these sessions when the man's partner tried to use the straw of a can of weatherproofing spray to keep him firm.
At some point the man's partner accidently hit the button on top of the can, deploying the foam inside of his penis.
The foam, normally used for home insulation, hardened and the man was left with several masses in the inside of his member and bladder.
A CT scan revealed the masses of the hardened insulation foam sprayed into the man's penis and bladder (shown, arrows). The 45-year-old and his partner had been inserting objects into his penis in a misguided attempt to treat his erectile dysfunction but their efforts went horrifically wrong when they used the straw connected to a can of weatherproofing foam
Pictured here is the total amount of insulation foam removed from the man's bladder and penis after it was unintentionally sprayed inside him. Some of the pieces measured up to 10cm in length and up to 4.3cm in width
The pieces of foam that became trapped inside the man's penis. These pieces proved too hard to remove by pulling them out of the penis so instead doctors opted to remove them by cutting a hole in the man's perineum, the area between the scrotum and the anus. Some of these pieces were up to 16mm in length
Urologists who detailed the incident in Urology Case Reports said the man waited three weeks to seek medical attention.
He only went for treatment after finding it increasingly sore and difficult to urinate. By the time he arrived at hospital he was passing blood.
WHAT IS IMPOTENCE?
Erectile dysfunction, also known as impotence, is when a man is unable to get or maintain an erection.
It is more common in the over-40s but affects men of all ages.
Failure to stay erect is usually due to tiredness, stress, anxiety or alcohol, and is not a cause for concern.
However, it can be a sign of an underlying medical condition such as high blood pressure or cholesterol, side effects of medication, or hormonal issues.
Lifestyle factors than can affect the condition include obesity, smoking, cycling too much, drinking too much, and stress.
Source: NHS Choices
Once he raised the alarm with medics, scans found various masses of the hardened foam with some measuring up to nearly 11cm (4 inches) long.
Urologists told the MailOnline that 'sounding', where men insert various objects into the opening of their urethra, was becoming an increasingly common 'home-remedy' among impotent men, despite carrying serious health risks.
Medical staff managed to extract the foam from inside the man's bladder during surgery, but the masses located in his penis proved more problematic.
Using specialised tools, doctors tried to grab the foam and pull it out through the opening of the man's penis but this proved impossible.
It became apparent that the man suffered from urethral stricture disease - a condition where the urethra, the tube carrying urine out of the penis, becomes scarred, causing it to narrow.
This scarred tissue effectively anchored the foam in place, making the attempts to manually extract it through the penis impossible.
Medics were forced to perform a perineal urethrostomy, where a new opening is made between the scrotum and the anus, to remove the remaining fragments.
This procedure diverts the urine stream away from the penis, with the new hole behind the scrotum used to expel urine.
Following the surgery, three tubes were inserted to help him pass urine and remove fluid from the procedure.
No issues were identified after the operation and the man is expected to undergo further surgery to repair his urethra but only after a psychiatric assessment.
Images taken from an endoscope, a long thin tube with a camera and light on it, during a failed attempt to pull out the insulation foam lodged within the man's urethra through the opening of his penis. Here a medics use a tiny grasping tool in an unsuccessfully attempt to pull out the trapped foam
Urethral stricture disease, here pictured from inside the man's penis is a a condition where the urethra, the tube carrying urine out of the body, becomes scarred causing it narrow. It is these rings of scar tissue that prevented medics from pulling out the foam through the opening of the penis leaving major surgery the only option
A graphic showing a perineal urethrostomy where a new opening is made between the scrotum and the anus. This new hole replaces the opening of the penis as the place a man urinates and ejaculates from. Surgeons were forced to perform this procedure to extract the last pieces of foam from the man's penis after attempts to pull the pieces out through the opening of the penis failed
What is sounding? And why can it be dangerous?
Sounding is when men insert items into the opening of the penis to enhance their sexual pleasure.
It usually involves specially designed tools made from glass or metal.
Doctors at clinic International Andrology London said there has been a ‘dramatic increase’ in the number of men having urethral problems due to sounding as men ‘look to expand their sexual activities and enhance their sexual experiences’
Men interested in the practice should understand the risks and purchase equipment from reputable businesses and ensure they do it hygienically.
But they warned the practice can damage the sensitive tissue in the urethral pathway, which releases urine and sperm.
It can also lead to a lack of bladder control and infection.
And the penis and urethra may even require surgery or implants to rebuild sensitive tissue.
Source: International Andrology London
The patient, who is currently homeless, will only qualify for an assessment if he 'achieves a stable living environment', the authors from New York and Pennsylvania wrote.
They said while it was rare for objects to get stuck in penises, other items such as straws, cotton tipped swabs, batteries or nails and cables had been reported.
Reasons for insertions could vary from a mental condition, to sexual gratification, to prisoners intentionally doing so to gain temporary release from prison for medical treatment, the urologists said.
They added that those who do insert objects into their urethras tend to be repeat offenders and may need psychiatric help.
Independent urologist Giangiacomo Ollandini, who works at both Milton Keynes University NHS Trust and health clinic International Andrology London, told MailOnline that while he had never heard of someone using a straw attached to a can of spray foam for sounding, fans of the sexual practise were quite inventive.
'Often any object with the correct size and shape is considered if there is no availability of a dedicated instrument,' he said.
Mr Ollandini said sounding has become something of a home-remedy for erectile dysfunction.
'Some persons end up practicing sounding because they are not able to have good erections anymore, and they insert a stiff rod within the penis to be able to have intercourse,' he said.
However the urologist added that this was definitely not an advisable way to treat erectile dysfunction.
'I have seen urethras severely injured by repeated sounding, and unfortunately they rarely recover very well,' he said.
Mr Ollandini said men, of any age, experiencing trouble maintaining or getting an erection to instead seek qualified medical advice from a health professional.
'It does not only represent a true threat for men’s, and their partners, quality of life, but also it is often a warning signal of the body that something in the cardiovascular system may not be quite right,' he said.
Mr Ollandini said the case also highlighted the need for healthcare workers to always treat patients with understanding and compassion no matter the extreme nature of cases like this one.
'Wrong attitude, the tone of the voice or a simple inquisitory sight may break the trust of our patients in us and generate shame, guilt, or anger,' he said.
'There is no space for gossiping, for judgmental attitudes, or for any form of personal comment,' he said.
Boy, 15, gets knotted USB cable stuck in his penis during experiment 'to work out how big his member was'
A 15-year-old boy who inserted a knotted USB cable into his penis ended up needing surgery after it got stuck inside him.
The unidentified teenager, of London, told doctors he inserted the cable to 'measure the length of his penis'.
But his experiment went wrong when the already-knotted cable got stuck, with both ends of the USB left hanging out of his member.
The boy made several attempts to remove it himself but this resulted in him urinating a large amount of blood, prompting his family to take him to A&E.
The X-Ray of the knotted USB cable after it became stuck inside the boy's body. The teenager inserted it into his penis in a sexual experiment gone wrong. After repeated attempts to remove the item by both himself and medical professionals were unsuccessful, an X-Ray was ordered to determine the exact size and location of the object ahead of surgery.
Hospital staff also failed to pull out the cable using special tools due to the position of the knot, doctors detailed in the journal Urology Case Reports.
The boy was urgently transferred to University College Hospital London for further treatment.
He asked to be examined without his mother present, and confessed to staff that he inserted the cable to measure his penis out of sexual curiosity.
After an X-ray revealed the exact size and positions of the knot, the teen was sent to surgery.
In an effort to remove the cable, surgeons cut lengthways into his bulbospongiosus muscle, an area between the genitals and the anus.
Medics managed to extract the knot through the incision and then cut it free from the rest of the cable.
Once the knot was removed, the remaining two pieces of the cable were pulled out the opening of his penis.
There were no complications in his recovery and he was discharged from hospital the next day.
Follow-up scans two weeks after the surgery revealed no lasting damage but doctors noted the boy will need ongoing monitoring in the future.
Although stating that cases like these are rare, the doctors said previous cases had shown a wide variety of objects had been inserted into the opening of penises in a similar manner.
Clio Kennedy and fellow medics who treated the boy listed needles, pins, iron wires and pistachio shells, as examples.
The most common reasons for doing so involve sexual curiosity, sexual practice after intoxication, and as a result of mental disorders, the doctors noted.
The insertion of objects into the opening of the penis for sexual pleasure is known as sounding, which carries a number of risks.
If an object gets stuck inside the penis it can cause several potential problems.
These can range from a burning sensation after urinating, large amounts of blood in the urine, an inability to urinate, and painful erections.
More serious complications, such as bladder a hole appearing in the bladder, and scarring of the tube that carries urine out of the body can require major reconstructive procedures to fix.
The doctors noted that a detailed history from patients on the object inserted and the method to do so are critical to health professionals investigation.
This highlighted the need to discuss the issue with patients in a 'a supportive and nonjudgmental manner' as patients may feel 'uncomfortable' about providing all relevant information, the doctors said.