You're having wild monkey sex with your beloved when, without warning, your bodies shift into an angle you weren't anticipating. You hear an unnatural "snap," "crack," or "pop." The molten river of pain that floods your nether region is enough to destroy your soul. You look down to see Mister Happy shrivel up and turn blue, like a small sea horse gasping on dry land. The Voice of Doom inside your head commands you to go to the nearest emergency room right away. Your penis has been broken.
Like a bone, an erect penis can break when confronted with a transverse force. Specifically, the corpus cavernosum, a mass of spongy erectile tissue that fills with blood to make a hard-on the thing it is, can rupture when bent too far. There are two corpi cavernosum, one on either side of the penis, and in cases of bending trauma one corpus will usually break. Blood from the ruptured corpus can leak into the intercellular spaces within the penis, causing a bruise. Bleeding outside a broken schlong is rare.
When you enter the emergency room you will be tempted to make up a story for the nurse, usually some vague murmurings about a sports injury. Do not do this. Be truthful, and answer each question in a loud, clear voice. All too many times, "The patient looks blankly at his wife and they mumble, 'It just started sticking out,'" one emergency room nurse explains. This behavior is common, she says, and not usually motivated by fear or sadness -- "more like morbid embarrassment."
E.R. staff are trained to care for their patients no matter what the injury, and they are too professional to snicker at your situation in front of you. They need to have the most accurate information about your problem if they are to treat you effectively. "We write down the earth-shattering answer, nodding our heads. VERY, VERY professional," as our nurse puts it, adding, "then we go to finish our notes in the office and laugh our weary asses off."
There are currently two philosophies on the proper treatment of penile fractures. The surgical approach gives uniformly good results, but is expensive and often not required -- two qualities HMOs frown upon. The more conservative approach meets the needs of most patients with broken whangs, but in rare cases it can result in infection or, even worse, in internal penile scarring!
The choice between surgical or conservative methods is made by a procedure called corpus cavernosography, and you will want to use all your manly powers of persuasion to convince the doctor to knock you out for this. To perform a cavernosography, Little Elvis will be washed and anesthetized, and then solemnly punctured with a 21-gauge butterfly needle, one of those large horse needles. The doctor may have to make several punctures to reach the correct corpus cavernosum. When the needle is placed correctly (the doctor will know this because blood will backtrack into the needle), 4 ounces of iodine solution are injected into the cavernosum. Your penis will swell until it resembles a hideously curved black-and-blue parody of an erection. A penis with a broken left-side corpus will bend toward the right, and vice versa.
At this time, "there is usually no display of emotion" from the patient, the E.R. nurse confides. "It's like when you get a rectal exam, and you detach and keep talking as if it's not really you it's happening to... just a rigid rod protruding from my penis, that's all." At this point, X-rays will be taken. Yes, that's right, X-rays. Dangerous ionizing mutagenic radiation will be sprayed all over your Special Area. Unfortunately, this is the only way to determine if your tunica albuginea, the white fibrous cloak that covers the corpus cavernosum, is damaged. If the tunica is damaged, you're definitely having surgery.
A badly ruptured tunica can also result in damage to the urethra, the penis' shaft to the outside world. Summon yourself to pee, so the doctor can examine your urine for traces of blood from the urethra. If you're as dry as the Sahara, the doctor may be forced to insert a catheter into your urethra, inject another 3 ounces of iodine-based fluid, and then clamp the Little Head shut while more X-rays are taken. "Catheterization hurts," says the ER nurse bluntly. Though she agrees that as a medical professional, "It is easy to catheterize a male," she admits that telling a man he's going to have a tube shoved down his dick "is met with horror, and my job as a nurse is to provide false reassurance." You really want to pee instead.
If your tunica is intact, you'll be sent home with an ice pack, codeine medication, antibiotics, and amyl nitrate poppers to prevent an erection. You'll be told to avoid intercourse until the bruise goes away. On rare occasions, when the corpus is badly damaged, your Best Friend will be placed in a splint for about a week. Try explaining that to the boys at the gym.
If the tunica is torn, you'll be rushed into surgery. The doctor will perform a circumcision if you haven't already had one. The skin of the penis will be peeled back, banana-fashion, and the injured region will be drained and repaired. You'll be home in a day or two, and back at work a few days after that. Your one-eyed mummy will be heavily bandaged for a week to 10 days, and the no erection rule will be strictly enforced.
Take your time. You'll be once again having wild monkey sex with your beloved in about a month, hopefully having learned your lesson about the fragility of man.
Patrick Di Justo is lucky to have only broken his heart.