Medical Aspects of Human Sexuality
by William A. Morton, Jr.
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 histrousers 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, I saw
somehalf-buried dark linear objects and asked the patient what they
were. Several days earlier, he said, 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 thespermatic 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 lunch time
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. I can only assume he abandoned this method of self-
[William A. Morton is a retired urologist residing in West Chester,