| One morning a doctor was
called to the emergency room by the head ER nurse. She directed him 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 scrotum, 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, the doctor saw some half-buried dark linear objects and asked the
patient what they were. Several days earlier, he replied, he had injured himself 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
wallboard.
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 hexachlorophene 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 coworkers. 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
piece of machinery. One day, as he approached orgasm, he lost his concentration and leaned
too close to the belt. When his scrotum 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. One can only assume he abandoned this method of
self-gratification. |
