Penile strangulation: an unusual sexual practice that often presents an urological emergency

Placement of constricting devices around the penis for autoerotic purposes or increasing of sexual performance represents a well-known challenge for urologists. Penile incarceration is a urologic emergency with potentially severe clinical consequences. In many cases a rapid intervention and a sudden removal of the foreign body it is enough so that patients need no further intervention. We report three different cases of strangulating objects (metallic ring, metal bearing and plumbing pipe) presented at our emergency department and three different methods of devices extraction practiced. Remove these devices can be challenging and often requires resourcefulness and multidisciplinary approach.