title: Safe emergency department removal of a hardened steel penile constriction ring.
abstract: BACKGROUND
  Penile constriction devices are used for the enhancement of sexual performance. These devices have the potential to become incarcerated, leading to necrosis and amputation if not removed promptly.
  
  
  OBJECTIVE
  This article presents a step-by-step approach for the safe removal of a hardened steel penile constriction device using somewhat unorthodox tools found in a hospital.
  
  
  METHODS
  We present a case of an incarcerated hardened steel penile constriction ring that was not able to be removed with conventional techniques. We describe a novel technique using an electric grinder and laryngoscope blade.
  
  
  CONCLUSIONS
  The technique described in this article is a valuable and relatively safe technique for the Emergency Physician to facilitate the timely removal of a hardened steel constriction device.
authors.affiliation: Department of Emergency Medicine, University of California, San Diego, San Diego, California, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Peay
authors.forename: James
authors.initials: J
authors.lastname: Smithson
authors.forename: James
authors.initials: J
authors.lastname: Nelson
authors.forename: Peter
authors.initials: P
authors.lastname: Witucki
mesh_terms: D000328:Adult; D003250:Constriction; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods; D004636:Emergency Service, Hospital; D006801:Humans; D008297:Male; D010413:Penis / Q000293:injuries*; D012725:Sexual Behavior; D013232:Steel
chemical_list: D013232:Steel