by William A. Morton, Jr. MD
taken from: Medical Aspects of Human Sexuality July 1991
One morning I was called to the emergency room by the head ER nurse.
She directed me to a patient who had refused to describe his problem other than
to say that he "needed a doctor who took care of men's troubles." The patient,
about 40, was pale, febrile, and obviously uncomfortable, and had little to say
as he gingerly opened his trousers to expose a bit of angry red and
black-and-blue scrotal skin.
After I asked the nurse to leave us, the patient permitted me to remove
his trousers, shorts, and two or three yards of foul-smelling stained gauze
wrapped about his scrotumm which was swollen to twice the size of a grapefruit
and extremely tender. A jagged zig-zag laceration, oozing pus and blood,
extended down the left scrotum.
Amid the matted hair, edematous skin, and various exudates, I saw some
half buried dark linear objects and asked the patient what they were. Several
days earlier, he replied, he had injured humself in the machine shop where he
worked, and had closed the laceration himself with a heavy-duty stapling gun.
The dark objects were one-inch staples of the type used in putting up
We x-rayed the patient's scrotum to locate the staples, admitted him to
the hospital, and gave him tetanus antitoxin, broad-spectrum antibacterial
therapy, and hexachlorine sitz baths prior to surgery the next morning. The
procedure consisted of exploration and debridement of the left side of the
scrotal pouch. Eight rusty staples were retrieved, and the skin edges were
trimmed and freshened. The left testis had been avulsed and was missing. The
stump of the spermatic cord was recovered at the inguinal canal, debrided, and
the vessels ligated properly, though not much of a hematoma was present.
Through-and-through Penrose drains were sutured loosely in site, and the skin
was loosely closed.
Convalescence was uneventful, and before his release from the hospital
less than a week later, the patient confided the rest of his story to me. An
unmarried loner, he usually didn't leave the machine shop at lunchtime with his
co-workers. Finding himself alone, he had begun the regular practice of
masturbating by holding his penis against the canvas drive belt of a large
floor-based peice of running machinery. One day, as he approached orgasm, he
lost his concentration and leaned too close to the belt. When his scrotum
suddenly became caught between the pulley-wheel and the drive belt, he was
thrown into the air and landed a few feet away. Unaware that he had lost his
left testis, and perhaps too stunned to feel much pain, he stapled the wound
closed and resumed work. I can only assume he abandoned this method of