WTF is 'Penile Strangulation' (And How Dangerous Is It?)

If you’ve ever seen TLC’s hit reality show “Sex Sent Me to the ER,” you’re probably all too familiar with the freak accidents that can put an end to a passionate hookup. And, sorry dudes, from broken dicks to misplaced vacuum cleaners, the penis bears the brunt of a significant number of these mishaps, especially when they're trying to improvise popular constrictive toys, such as cock rings.

To be fair to cock rings, when used correctly, are usually safe and can offer some stellar sexual benefits, including helping an erection stay harder and last longer as a result of more blood flow getting trapped in the penis. But there’s also a small but definitely scary risk: penile strangulation. Yes, unfortunately, you can actually choke your dick.

What is penile strangulation?

Penile strangulation happens when someone puts an object, such as a too-small cock ring, rubber band or the mouth of a water bottle, around their penis, leading to swelling of the penile shaft. Once swollen, the object becomes almost impossible to remove (picture trying to get a ring off a swollen finger, except imagine how much more sensitive the penis is and how much more difficult that would make removal).

Although rather rare, penile strangulation can actually pose some very real—even life-altering—risks down there. Think of medical emergencies such as gangrene or permanent urethral damage, as a 2020 case report in the African Journal of Urology points out. One symptom of penile strangulation is extreme difficulty peeing because of excessive pressure forcibly narrowing the urethra.

At the ER, they may opt for a small saw to remove stubborn metal objects or scissors to carefully cut stretchier materials—please, do not try this at home.

However, “you can try to manually reduce the swelling, which is the reason an object gets stuck, with ACE Wrap, similar to how you remove a wedding ring that gets stuck,” said Rena Malik, M.D., a urologist based in Baltimore.

What you’ll do is wrap the penis with the elastic bandage above the stubborn object to compress the swollen area just enough to slip it off. You can also try lubing up the stuck device and carefully twisting it back and forth until it slides off of the penis.

Penile strangulation can actually pose some very real—even life-altering—risks down there.

Good news, though: There’s no need to ditch experimenting with penis constriction from your bedroom routine if that’s what helps you stay hard and/or what gets you off. Just stick to devices made specifically for sex, and things won’t go south.

“[Penile strangulation] happens more often when people put other objects on their penises because they don’t have a sex toy or they get curious. Typical sex toys are usually not the ones that end up getting stuck because they are either made with silicone, or they have a clasp-type opening mechanism,” Malik said. “If you are going to use a toy, make sure that they are elastic and that you can stretch them or that they have some sort of opening mechanism. Those devices are safe.”

Just tread carefully when you’re under the influence. According to Malik, penile strangulation happens frequently when someone is inebriated and forgets to remove a constrictive device from the penis; then they wake hours later and aren’t able to free themselves of the object. And the longer the object is stuck on the penis, the more dangerous it gets.

Penile strangulation point of no return

In the most severe cases, penile strangulation can completely cut off circulation to the penis, which can cause the tissue of the penis to turn black and die (search Google Images at your own risk). This point of no return, known as penile necrosis, usually results in the complete amputation of the penis.

“If it doesn’t come off, I wouldn’t spend too much time trying to do it yourself,” Malik said. “If you can’t get it off, it’s not going to get better on its own.”

If the object is removed within 24 hours of initial placement, there should be minimal to no long-term consequences, Malik said. To avoid irreversible penile damage, head to the ER as soon as you suspect needing some extra help removing the stubborn object.

Of course, no one wants to become the next subject of “Sex Sent Me to the ER,” but this is one of those cases where you just need to swallow your pride and head to the hospital. After all, a couple of hours of mild embarrassment is nothing compared to a lifetime without your penis.