The following is the _Unusual_Case_ case column from the July 1991
\nissue of the trade magazine _Medical_Aspects_of_Human_Sexuality_, by
\nWilliam A. Morton, Jr.<\/p>\n
Scrotum Self-Repair<\/p>\n
One morning I was called to the emergency room by the head ER nurse.
\nShe directed me to a patient who had refused to describe his problem
\nother than to say that he “needed a doctor who took care of men’s
\ntroubles.” The patient, about 40, was pale, febrile, and obviously
\nuncomfortable, and had little to say as he gingerly opened his
\ntrousers to expose a bit of angry red and black-and-blue scrotal skin.<\/p>\n
After I asked the nurse to leave us, the patient permitted me to
\nremove his trousers, shorts, and two or three yards of foul-smelling
\nstained gauze wrapped about his scrotum, which was swollen to twice
\nthe size of a grapefruit and extremely tender. A jagged zig-zag
\nlaceration, oozing pus and blood, extended down the left scrotum.<\/p>\n
Amid the matted hair, edematous skin, and various exudates, I saw some
\nhalf-buried dark linear objects and asked the patient what they were.
\nSeveral days earlier, he replied, he had injured himself in the
\nmachine shop where he worked, and had closed the laceration himself
\nwith a heavy-duty stapling gun. The dark objects were one-inch
\nstaples of the type used in putting up wallboard.<\/p>\n
We x-rayed the patient’s scrotum to locate the staples; admitted him
\nto the hospital; and gave him tetanus antitoxin, broad-spectrum
\nantibacterial therapy, and hexachlorophene sitz baths prior to surgery
\nthe next morning. The procedure consisted of exploration and
\ndebridement of the left side of the scrotal pouch. Eight rusty
\nstaples were retrieved, and the skin edges were trimmed and freshened.
\nThe left testis had been avulsed and was missing. The stump of the
\nspermatic cord was recovered at the inguinal canal, debrided, and the
\nvessels ligated properly, though not much of a hematoma was present.
\nThrough-and-through Penrose drains were sutured loosely in site, and
\nthe skin was loosely closed.<\/p>\n
Convalescence was uneventful, and before his release from the hospital
\nless than a week later, the patient confided the rest of his story to
\nme. An unmarried loner, he usually didn’t leave the machine shop at
\nlunchtime with his coworkers. Finding himself alone, he had begun the
\nregular practice of masturbating by holding his penis against the
\ncanvas drive-belt of a large floor-based piece of machinery. One day,
\nas he approached orgasm, he lost his concentration and leaned too
\nclose to the belt. When his scrotum became caught between the pulley-
\nwheel and the drive-belt, he was thrown into the air and landed a few
\nfeet away. Unaware that he had lost his left testis, and perhaps too
\nstunned to feel much pain, he stapled the wound closed and resumed
\nwork. I can only assume he abandoned this method of self-
\ngratification.<\/p>\n
[William A. Morton is a retired urologist residing in West Chester,
\nPennsylvania.]<\/p>\n
