We report a case of penile strangulation in an 82-year-old man who inserted the penis up to the penile base into a plastic bottle to obtain sexual pleasure and prolonged erection. He developed edema of the distal penis, which resulted in penile entrapment at the neck of the bottle. He was unable to remove the penis from the bottle and presented to our hospital 3 days after this event. On examination, the penis was edematous with foul odor, and the penile skin appeared black. He was diagnosed with penile strangulation and suspected sepsis. The neck of the plastic bottle strangled the penile root, and we could not manually release the penile strangulation. The patient was transferred to the operating room, and an orthopedic ring cutter was used to cut the neck of the plastic bottle. We observed necrosis at the distal penile root and performed emergency total penectomy. The patient was administered postoperative antibiotics; however, his general condition did not improve, necessitating additional debridement and removing residual urethra for management of the skin infection. The patient recovered completely following this multidisciplinary treatment approach.
