A fascinating case study entitled “Penile Incarceration Secondary to Masturbation with a Steel Pipe” was recently published in the Archives of Sexual Behavior. Based on the title alone, I knew I had to blog about it. As it turns out, men have been “incarcerating” their penises for more than 250 years, sometimes resulting in rather unpleasant consequences and inventive “jailbreaks” .
I should start by defining “penile incarceration” as the placement of a (usually) metallic object around the base of the penis so as to restrict the flow of blood out of the genitals. By keeping more blood in the penis, the result is a firmer and longer-lasting erection. Men who engage in this activity usually do so to enhance sexual arousal or pleasure, or because they have a fetish for it . What makes “incarceration” different from using a simple “C-ring” (or "cock ring") is that C-rings are usually larger, made of rubber, and often have a release latch, which makes removal relatively easy after use. The objects used for incarceration are typically much smaller, very rigid, and form a closed loop, making them difficult to remove and sometimes creating urological emergencies (of course, certain C-rings can have this effect too if individuals are not careful). As a result, penile incarceration is often referred to as penile strangulation because it creates such a tight and unyielding grip on the genitals.
Hundreds of cases have been reported in the medical literature, with men using a variety of objects for incarceration, such as wedding rings, metal washers, and plastic bottle necks. Getting back to the new case study reported in the Archives of Sexual Behavior, the patient had put a 6 centimeter (2.4 inch) metal pipe around the base of his penis that had a diameter of just 2 centimeters (about three-quarters of an inch) . The patient, described as an alcoholic married man with two kids, had used the pipe during a group masturbation session with some of his friends; however, the pipe became stuck in place. After 12 hours of pain and being unable to urinate, the patient (who was also incredibly drunk) finally went to the hospital, where doctors removed it with the use of a mini circular saw that they borrowed from the local fire department.
Believe it or not, emergencies like this are common enough that some fire departments keeps such saws on hand just for this purpose! In other cases studies I came across, the strangulating devices were removed with everything from electrician’s soldering guns to dental drills to penile surgery.
I should point out that penile incarceration can have devastating consequences if the item gets stuck and is left untreated, including necrosis (i.e., death) of penile tissue, erectile dysfunction, and gangrene. Penile strangulation quickly becomes a medical emergency and help should be sought immediately to reduce the risk of permanent damage.
A few considerations for people who enjoy the erection-enhancing effects of penile incarceration: first, it would be wise to use a device made specifically for this purpose that has a release latch or is made of a very stretchy material. Second, it is advisable to use it for no more than 30 minutes at a time in order to reduce the risk of complications.
 Kumbhar, Dasharathimurumu, & Bhargavpak (2011). Acute penile incarceration injury caused by plastic bottle neck—A rare presentation. International Journal of Biological & Medical Research, 2, 1184-1185.
 Van Ophoven, A., & De Kernion, J. B. (2000). Clinical management of foreign bodies of the genitourinary tract. The Journal of Urology, 164, 274-287.
 Flores-Martin, J. F., Puche-Sanz, I., Vazquez-Alonso, F., Vicente-Prados, J., & Cozar-Olmo, J. M. (2013). Penile incarceration secondary to masturbation with a steel pipe. Archives of Sexual Behavior, 42, 337-339.
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