He said that he was in his prison cell with his cellmate and was trying to figure out how
he could show his love for his wife before she got there for the conjugal visit. His
cellmate had rigged together this device with a paper clip - oh my god I'm horrified - dude
what are you doing it says wrench he was tattooing my name on his penis oh
okay that makes more sense okay guys if you're gonna get your genitals tattooed please do it
by a professional and not with a paper clip okay I hope everyone knows that but like
y'all it's not worth it, it's not worth it to be in the ER like that guys. Have you ever watched
this show "Sex sent me to the ER"? No? Ne neither but today i'm reacting to a episode of sex sent
me to the er and this is season two episode 10 and it's called prison problems I've never
watched this show before and i'm kind of curious to see what we're gonna see I'm Dr. Rena Malik,
urologist and pelvic surgeon, and if you're new here I react to videos sometimes like this I talk
about urologic conditions men's sexual health female sexual health urinary problems kidney
stones cancers all sorts of things urology so if you like what you see make sure you subscribe and
hit that notification bell so you make sure you don't miss new content from me every single week.
after the couple's conjugal visit his
thing wouldn't go down how long have you had the erection five days
like a really good time but it can actually be a very serious problem it's stuck i want it to wow
holy moly that's charles chatsworth find out that this gentleman is a notorious financial embezzler
and this woman was his wife hey doc hey how's it going after the couple's conjugal visit his
thing would go down i didn't know those were real things something is kind of going on so wife had
to bring him in his dow jones is up and it has not gone down yet his what he still has the erection
doc how long is this thing going to take i have to examine him when we get him in the
bay let's get some blood tests i knew that we had to get this patient examined as quickly as
possible so we could get down to what's causing this problem how long have you had the erection
while i guess we're talking about a number of hours here
five days five days
five days that's an insane amount of time i'm going to talk about this later at the end
exactly when you should go to the er and why you should but basically if it's longer than
four hours go to the emergency room do not wait do not pass go do not collect
dollars just go straight to the emergency room okay
five day erection may sound like a really good time but it can actually be a very serious problem
we need to figure out what's causing it pretty fast why did you wait so long to come in you don't
brag about a fiber erection in prison i understand that but your penis could be severely damaged
what's the big deal i mean it doesn't even hurt doesn't matter he told me that he was not in
pain i was incredibly surprised the prisoner has priapism it's an erection that goes on for longer
than normal i asked nurse caitlin to draw some blood tests and if any of those come back positive
that's pretty indicative of ischemic priapism which means permanent damage so the fact
that it's not painful is telling me that this might be what's called a non-ischemic priapism
as he's mentioned they want to figure out whether it's ischemic or non-ischemic
and if it's ischemic that's more of an emergency and usually those erections are extremely painful
and they you would not be waiting around for five days with that kind of pain
however because he's saying it's not painful it's probably related to some sort of trauma
although we usually don't see that after a sexual encounter so let's see what else is going on here
he had been concealing it from everybody in prison he had concealed it from his wife
and when i looked at it i could understand why at the time it seemed like a good idea
but now not so much he said that he was in his prison cell with his cellmate and was trying to
figure out how he could show his love for his wife before she got there for the consequences listen
i'm a pro and if we don't do this right now we won't heal before your conjugal his cellmate had
rigged together this device with a paper clip oh my god i'm horrified dude what are you doing
okay that's enough love inmates are crafty how are they even getting that shot i'm just thinking what
the heck did you do to yourself does that say beg roy wait who's roy what i think it says rey
it says reg he was tattooing my name on his penis oh okay that makes more sense it hurt
too much to finish do you know how sensitive that areas regina is usually the adventurous one
i want to wow her him and his wife are very much in love and while he's been in prison they haven't
had the opportunity to spend that much okay guys if you're gonna get your genitals tattooed please
do it by a professional and not with a paper clip okay i hope everyone knows that but like
y'all it's not worth it it's not worth it to be in the er like that
um also how did they get that shot where they're looking under the sheet like did they put the
camera right next to his penis and then get a shot like that i mean that's a little creepy all right
let's see here the urologist looks over the case and wants to do further tests to determine the
appropriate diagnosis and the right treatment for the patient what does reg mean oh his wife's name
and you've had the tattoo five days i'm gonna draw some blood for further testing
the nurse already did that oh from his penis oh so this guy is here with an erection that won't
go away after he got a tattoo and what's that called that's called a priapism and when you come
in with a priapism it can be ischemic meaning that there's loss of blood flow to the penis
or it can be non-ischemic and that means that it's usually due to some sort of trauma
and the way you determine that is by checking a blood gas of the penis and based on the
results of the blood gas of the penis you can determine whether it's ischemic or non-ischemic
and depending on that the treatments are very very different let's see what this guy has
prioritism only a specialist can take blood from the penis which is why we needed him
well we are now sure that this is non-ischemic priapism non-ischemic priapism
means that too much blood is flowing into the penis but not enough blood is flowing out
that's good because at least it's getting nutrients and oxygen and it has a lower risk
of dying finally some good news but if it isn't resolved it'll be semi-erected at all times
that's some good news why i'm just trying to lighten the mood
wait how exactly was he able to see that this guy has a non-ischemic prioritism by just looking at
the blood i mean yes in theory if it's very very dark the blood coming out that looks
like old blood that's very likely ischemic versus if it's kind of bright red it's more
likely non-ischemic but he just like came out of the sheets and was like it's not ischemic um
so i think what he's going to start saying is you know this is likely due to the trauma from
the actual tattooing process and typically like he said the treatment for this is we just watch and
wait you can at times go to have what's called an angiogram done with interventional radiology where
they inject some dye into the blood vessels to the penis to see if there's any sort of abnormality
like a malformation in those cases they can actually coil the malformation and that can help
alleviate some of the erection and the pain that's associated with the erection
typically the difference is with a priapism that's due to an ischemic process very often due to if
they've taken medication for erectile dysfunction which can include oral medications or injections
in the penis more commonly with injections in the penis or if they've taken certain medications that
can cause priapism or if they have something like sickle cell anemia which is a disease in which
the blood cells are misshapen or misformed it's actually an inheritable disease that people get
and because there's not enough normal red blood cells they can often lose oxygen and one of those
areas where they can lose oxygen is actually in the penis for men and so they can come to the
hospital with priapism or an erection that won't go away this is often an ischemic priapism and
when you have an ischemic priapism you actually have to drain the blood from the penis itself
to help the erection go down and this can often be very very painful i actually reacted to a grey's
anatomy video of an ischemic priapism so you can check that out and learn a little bit more about
that should be a little cold the urologist runs the ultrasound oh there it is there's the cause
you have penile fistulas well what does that mean so dramatic it forms the presence of these things
called fistulas which are connections in between the penis's arteries and the penis's veins which
cause damage between the penis's blood vessels you see this so guys i you usually don't diagnose
this on an ultrasound most often it's done by a radiologist an interventional radiologist
who will do an arteriogram so they'll actually inject dye into the vessels and they'll be able
to see the connection it's very difficult to see an ultrasound and i highly doubt a urologist would
actually be able to do that unless they are very highly skilled and have done a lot of ultrasound
it's not something certainly that i do and also it's kind of really poor bedside manner
and everyone's standing there watching this happen when you're doing a management of priapism
in the er typically the patient is accompanied by their partner spouse whatever and then obviously
the urologist would be there and sometimes when you're doing a procedure that the
emergency room is not familiar with they'll also ask to come observe the procedure and that can be
the emergency medicine physician or if you're at a teaching hospital there can be residents
or fellows there as well who are learning how to do that so it can be a lot of people although the
way this is going down is just very very dramatic and not at all realistic you see this all the time
without home tattooing it's incredibly dangerous to tattoo down there your body punctured your skin
too deeply i don't see this at all it's really hard to gauge depth when you're tattooing such
a delicate organ the holes in the blood vessels cause fistulas the patient's incredibly lucky that
the fish list didn't interfere with this urethra and cause any urinary issues okay so a fistula is
a connection between an artery and a vein and it's not always necessarily near the urethra
so it's very actually rare that you would get an arterial venous malformation that would
somehow also injure the urethra maybe the needle that they were using to tattoo could injure the
urethra again the urethra is the tube where you pee from and so i don't know what they're
really getting at here so interestingly this urologist says he sees this all the time well
first of all i don't see a lot of patients with penile tattoos certainly i've seen a handful
maybe more than a handful but i've seen you know several but not like hundreds and i actually
looked this up in the literature and i found one report of a non-ischemic priapism following a
tattoo of the penis in the middle east and they report they are the first ever reported in the
literature that doesn't mean that it's the only one that's ever happened but i would claim to say
that it's probably very infrequent as a urologist i'm more often seeing men in the er with ischemic
priapisms like i talked about in my last video reacting to grey's anatomy having a non-ischemic
priapism is you know more rare i'd probably guess that on the order of every five ischemic priapisms
i'll see one non-ischemic priapism and that's just my experience charles is lucky there aren't
further complications but without surgery to implant a shunt to drain the blood this could
persist indefinitely then do the surgery however with surgery he runs the risk of having permanent
erectile dysfunction so i don't necessarily agree with the management of this non-ischemic priapism
you don't do a shunt for a non-ischemic process again that's something that you would do for an
esthemic process in this case you would again do the arteriogram with interventional radiology and
then try to embolize that malformation and there's different kinds of materials that the radiologist
can use they can use gels or coils so absorbable or non-absorbable materials that can help you know
close off this malformation and if those don't work and when they do work they're about 90
successful if they don't then you can do some sort of surgical ligation of the malformation however
i've never had to do that personally because over time these usually tend to get better at any time
you do any type of surgery there is a risk of erectile dysfunction but when you are able to
embolize the malformation typically the large majority of people will be able to retain their
erectile function all right so i had to get up and close the blind that was putting all those
lines on my face but anyways what i really wanted you guys to take home from this is that having
an erection that lasts longer than four hours is an emergency no matter what you think the reason
is that this happened you need to get to the emergency room the longer you wait the more likely
you could get permanent damage to your penis and have erectile dysfunction it's not fun it's not
cool and usually it's extremely painful so don't wait don't delay get to the emergency room and
you will see a urologist there who will be able to evaluate you and manage you appropriately i
get it it can be super embarrassing to come in and talk about your genitals with a complete stranger
but it's a lot worse if you wait and then you have problems with erections for the rest of your life
okay i don't want to end on that really depressing note but i want to thank you guys so much for
watching if you have enjoyed this sex sent me to the er reaction comment below let me know
there's a whole season of sex sent me to the er episodes and i would be happy to react to more
of them if you like it as always remember to take care of yourself because you're worth it