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An Indonesian man broke his penis during “violent” sex with his wife.
The 44-year-old from Bali heard "a cracking sound" while his lover was in the cowgirl position, followed by excruciating pain.
She was on top of him when his penis slipped out and she slammed her perineum, the area between her vagina and anus, onto it.
His erection disappeared immediately and gruesome images showed his penis hanging at a right angle.
The man, who has not been named, waited three hours before going to hospital but became concerned when his penis swelled and blood began to flow from the tip.
Doctors were forced to “unhandle” his penis – meaning peeling away the skin – to examine the injuries.
They found a 3cm-long fracture in the spongy tissue in the shaft of the penis, which swells with blood during an erection. He also ruptured his urethra.
A 44-year-old man required emergency surgery after his wife broke her penis after landing awkwardly on the organ during "vigorous sexual activity" (stock image).
The story was reported in the International Journal of Surgery Case Reports by medical professionals at Sanglah General Hospital.
Penile fractures are considered a rare injury but require emergency treatment when they occur.
It usually happens during sex and the most common position is “doggy style” when a man is behind or cowgirl when the woman is on top.
Shortly after the accident, the man went to the emergency room, where medics inserted a thin, flexible camera into his penis to examine the damage.
They found that the man's urethra, the tube in the penis that allows urine to escape from the body, had ruptured.
They then rushed him into surgery and, after removing the penis, found the fracture.
After the fracture was stitched back together, the man was given an erection with medication to ensure no blood could leak, and his penis was carefully bandaged.
After 21 days, the 44-year-old reportedly made a full recovery and was able to maintain an erection and urinate normally.
Urologist Dr. Muhlis Yusuf, one of the medics who treated the man, said of the case that various sexual positions could lead to penis fractures.
In the case report they wrote: “The most common violent sex position was doggy style.
“Another study also reported that penile fracture usually occurs when the woman is in a superior position.”
Dr. Yusuf added that a possible complication of these types of injuries is men feeling embarrassed about the injury and therefore delaying seeking treatment.
Doctors did not say exactly when the man was injured.
While the case report stated that the man, who had fully recovered, was able to have sex again without pain, it detailed whether he was given painkillers or antibiotics during his recovery.
It also didn't explain whether the stitches the man received during his surgery were dissolvable or had to be removed at a later date.