This article was taken from the Moscow Times archive and was first published on March 13, 2001.
The coffinmaker was hard at work when the accident happened. His circular saw suddenly got caught up in his trousers, and the man and the five bits of himself he'd just cut off were soon speeding their way to the hospital to be stitched back together again.
Luckily for the coffinmaker, he was taken to hospital No. 50 and the specialized department, Muzhskaya Skoraya Pomoshch, or Emergency Care for Men, headed by urologist Professor Pyotr Shcheplev.
For what was chopped up was no ordinary limb.
Emergency Care for Men caters exclusively to accidents to the male sexual organ. Its doctors made the coffinmaker, whose penis was cut into six pieces by the saw, whole again and fully functioning.
The service received recognition by its nomination for the $10,000 Prizvaniye prize for medicine, a new prize set up by show business stars. The winner among the seven nominees is to be announced in June.
The idea for the center, which began operating a year and a half ago, grew out of Shcheplev's experience as a urologist and his interest in furthering the little known field of andrology. Andrology, as Shcheplev sees it, is a multidisciplinary field that focuses on the male sexual organ in a much wider way than a urologist or endocrinologist would.
"There is a large mass of information and it needs to be put into the hands of one specialist," said Shcheplev, who is president of the Russian Association of Andrologists.
"There is a science for women's sexual organs," Shcheplev said, speaking in his office in the hospital near Timiryazevskaya metro. "But there's no analogous specialist for the male organs or for the reproductive system of the male.
"There's no system so that a man can stay a man."
At hospital No. 50, Shcheplev and four other doctors not only deal with emergencies but do everyday urology work and academic research. Next month, Shcheplev is traveling to Kislovodsk for a conference that has on its agenda lectures such as "How to correctly implant different models of sexual organ prostheses."
"The penis is a very complicated organ," Shcheplev said, sitting in front of a fridge with a photograph of the large member of a post-op patient stuck on the door. An andrologist, he said, needs the knowledge and skills of a urologist, microsurgeon and plastic surgeon, among others.
"The sexual member has many nuances and many peculiarities that you need to know. And you can't know them just from a book. You need to do it."
The center gets a lot of practice with a regular supply of broken, amputated and swollen members coming in its doors.
One of the most common problems that requires urgent medical help is a priapism or an erection that refuses to go down. "The penis can't stand for a long time," said Shcheplev, explaining that if action is not taken within four to six hours the penis tissue can begin to suffocate because of a lack of oxygen and the patient will become impotent.
It also hurts, he said, describing the pain as similar to an arm or a leg that has fallen asleep.
Few realize the seriousness of the condition, though, and sufferers who have rung the emergency services have been told to put a cold towel on it and wait for the swelling to go down, according to Shcheplev.
Other common problems include a break or rupture in the penis. It is impossible to break the penis when it's flaccid, but once it's erect severe pressure can rupture the corposa cavernosa — the three tubes that fill with blood to make the penis erect. Cases reported often include when a woman tries to jump on her partner and misses.
As well as being extremely painful — a loud popping sound is often heard when the penis "breaks"— it can cause severe problems, both sexually and with the urinary tract, if not treated immediately. "There's a feeling like something is broken, like bone, although there isn't any bone there," Shcheplev said.
Many emergencies are self-inflicted through the use of creams or injections that promise to enhance sexual performance but have only the reverse effect.
"We've been trying to get rid of this crap," Shcheplev said while waving a small bottle of clear liquid that is supposed to prolong an erection. It has been on sale at various clinics and caused a number of injuries, he said.
"Hey, has anyone got a nut?" he shouted to his assistant before finding an old heavy metal one that had been cut off a patient. The nut had fitted easily over the flaccid penis but become stuck once it was erect.
A number of patients have come in having experimented with limited success with various objects — some stuck in the urinal tract, others wrapped around the penis itself.
Shcheplev said one old folk tale may be the cause of many a painful night. The tale says that if a bride places a ring on her husband's penis then he will perform well until old, old age.
A fashion for penis extension in less-than-reliable clinics has seen many a patient turn up at the hospital door. Other less technical attempts at extension — such as hanging a weight on the penis — also have led to the same place.
Steady Flow of Clients
Shcheplev remembers when an operation to sew on an amputated penis would cause a sensation. Now, if not commonplace, it's not that unusual and he reels off a lists off encounters —a jealous wife, the bite of a lover or man's best friend — that have resulted in a severing of the penis.
He has no ready numbers for the number of amputations his center has handled, but said it has been as many as three a week.
The center also does implants of prosthetic penises, which have their hiccups and can break or split. "As with a car it needs a checkup," Shcheplev said.
The number of implants is growing in Russia and is now about 3,000 a year, although this is only about one-tenth the number in the United States, he said.
Patients also seek help for organs that are too small or too big — "extremely rare," said Shcheplev of the latter.
His center plans to hold seminars for doctors and emergency service workers to help increase awareness of the injuries particular to men.
"If a penis has some defect, it brings a big enough psychological blow," said the good-humored doctor with a mission.
"It's a man's dignity."