Zachary Levin: When you get one of these untimely erections, is it dangerous to try to hide it by forcing it into a position it doesn't want to be in?
VI: Yes. When a penis is erect, it's as rigid as wood. Now, it might be green wood, but if you bend it, you could break it. This usually happens during sex. I saw a patient recently whose very large girlfriend was on top of him. Her weight pressed down on his very rigid erection the wrong way. His penis was fractured. He had to go to the operating room and get it sewn up.
Zachary Levin: Talk to me about priapism.
VI: Priapus was a little Roman god-he was only about six inches tall, but is always shown in statues with a huge penis. Priapism is the condition of having an erection that will not go down. It's not common, except in people who are predisposed to it. Some people with head trauma, like concussions, will come to the emergency room in a priapistic state. Young black men who have sickle cell anemia are also at risk, because their blood clots, usually in the penis. Some drugs can cause priapism as a side effect, too.
Zachary Levin: What's the stuff, often called pre-come, that leaks out of the penis during foreplay?
VI: The urethra of the penis has little glands along it that provide pre-lubrication. It's something that's evolved over time. Evolution has rewarded animals who reproduce. So anything that helps deliver semen to the uterus is going to survive. This pre-lubrication of the urethra helps it open up, so that semen comes down unfettered. Pre-come is comprised of one of two things (and sometimes both): some of it is the secretions of the little glands of the urethra, and some of it could actually be prostatic secretions, which is true semen.
Zachary Levin: Is there enough sperm in pre-come to get someone pregnant?
VI: You have to assume that it's strong enough. Also, it's not like a washing machine where it suddenly switches to spin-modeor, in this case, urethral versus prostatic secretionsand you can't tell the difference. Better to be safe than sorry and keep it away from the vagina.
