Retention of Foreign Bodies in the Pelvis.--It is a peculiar fact that foreign bodies which once gain entrance to the pelvis may be tolerated in this location for many years. Baxter describes a man who suffered an injury from a piece of white board which entered his pelvis, and remained in position for sixteen and a half years; at this time a piece of wood 7 1/2 inches long was discharged at stool, and the patient recovered. Jones speaks of a case in which splinters of wood were retained in the neighborhood of the rectum and vagina for sixteen years, and spontaneously discharged. Barwell mentions a case in which a gum elastic catheter that had been passed into the vagina for the purpose of producing abortion became impacted in the pelvis for twenty months, and was then removed.
Rupture of the Male Urethra.--The male urethra is occasionally ruptured in violent coitus. Frank and the Philosophical Transactions are among the older authorities mentioning this accident. In Frank's case there was hemorrhage from the penis to the extent of five pounds. Colles mentions a man of thirty-eight, prone to obesity, and who had been married two months, who said that in sexual congress he had hurt himself by pushing his penis against the pubic bone, and added that he had a pain that felt as though something had broken in his organ. The integuments of the penis became livid and swollen and were extremely painful. His urine had to be drawn by a catheter, and by the fifth day his condition was so bad that an incision was made into the tumor, and pus, blood, urine, and air issued. The patient suffered intense rigors, his abdomen became tympanitic, and he died.
Postmortem examination revealed the presence of a ruptured urethra.
Watson relates an instance of coitus performed en postillon by a man while drunk, with rupture of the urethra and fracture of the corpus spongiosum only. Loughlin mentions a rupture of the corpus spongiosum during coitus. Frank cites a curious case of hemorrhage from a fall while the penis was erect. It is not unusual to find ruptured urethrae following traumatism, and various explanations are given for it in the standard works on surgery.
Fracture of the Penis.--A peculiar accident to the penis is fracture, which sometimes occurs in coitus. This accident consists in the laceration of the corpora cavernosa, followed by extensive extravasation of blood into the erectile tissue. It has also occurred from injury inflicted accidentally or maliciously, but always happening when the organ was erect. An annoying sequel following this accident is the tendency to curvature in erection, which is sometimes so marked as to interfere with coitus, and even render the patient permanently impotent.
There is an account of a laborer of twenty-seven who, in attempting to micturate with his penis erect, pressed it downward with considerable force and fractured the corpora cavernosa.
Veazie relates a case of fracture of the corpora cavernosa occurring in coitus. During the act the female suddenly withdrew, and the male, following, violently struck the pubes, with the resultant injury. Recovery ensued. M'Clellan speaks of removing the cavernous septum from a man of fifty-two, in whom this part had become infiltrated with lime-salts and resembled a long, narrow bone. When the penis was erect it was bent in the form of a semicircular bow.
The Transactions of the South Carolina Medical Association contain an account of a negro of sixty who had urethral stricture from gonorrhea and who had been treated for fifteen years by caustics. The penis was seven inches in circumference around the glans, and but little less near the scrotum. The glans was riddled with holes, and numerous fistulae existed on the inferior surface of the urethra, the meatus being impermeable. So great was the weight and hypertrophy that amputation was necessary.
John Hunter speaks of six strictures existing in one urethra at one time; Lallemand of seven; Bolot of eight; Ducamp of five;Boyer thought three could never exist together; Leroy D'Etoilles found 11, and Rokitansky met with four.
Sundry Injuries to the Penis.--Fabricius Hildanus mentions a curious case of paraphimosis caused by violent coitus with a virgin who had an extremely narrow vagina. Joyce relates a history of a stout man who awoke with a vigorous erection, and feeling much irritation, he scratched himself violently. He soon bled copiously, his shirt and underlying sheets and blankets being soaked through. On examination the penis was found swollen, and on drawing back the foreskin a small jet of blood spurted from a small rupture in the frenum. The authors have knowledge of a case in which hemorrhage from the frenum proved fatal. The patient, in a drunken wager, attempted to circumcise himself with a piece of tin, and bled to death before medical aid could be summoned. It sometimes happens that the virile member is amputated by an animal bite. Paullini and Celliez mention amputation of the penis by a dog-bite. Morgan describes a boy of thirteen who was feeding a donkey which suddenly made a snap at him, unfortunately catching him by the trousers and including the penis in one of the folds. By the violence of the bite the boy was thrown to the ground, and his entire prepuce was stripped off to the root as if it had been done by a knife. There was little hemorrhage, and the prepuce was found in the trousers, looking exactly like the finger of a glove. Morgan stated that this was the third case of the kind of which he had knowledge. Bookey records a case in which an artilleryman was seized by the penis by an infuriated horse, and the two crura were pulled out entire.
