Dr. Kanwal Bawa worked in the ER for nine years and treated people with sex injuries.
She told Insider some patients "made up" stories about how and why the mishaps happened.
The doctor wants people to enjoy sex and have fun — but to avoid the pitfalls and pratfalls.
Patients are embarrassed, but withholding the truth can hurt.
But, she told Insider, some of the most memorable — and challenging — crises were related to people's sex lives.
"I treated so many accidental injuries that resulted from masturbation, sex toys, oral sex, vaginal sex, and anal sex," Bawa said, adding that she was sometimes surprised by the manner in which a patient had managed to get hurt.
"People are usually very embarrassed, and it can take them awhile to tell you what happened," she said. "It can make it difficult to treat the problem if they're not open about the circumstances."
But, she said, they usually end up telling the truth when she warns that their painful symptoms will likely last longer or get worse if they don't.
"It's much better to get over your fear of judgment and be direct," the doctor, who trained at the Cleveland Clinic in Ohio, said, adding: "The staff in the ER will have seen a lot of similar injuries before and will just do their job as quickly and efficiently as they can."
Still, she said, "there are times when it's hard to keep a straight face because the circumstances are so bizarre."
Bawa told Insider she'd treated sex-related injuries varying from relatively straightforward complaints like foreign objects lodged in various orifices to life-threatening emergencies such as internal lacerations.
Her most serious case, she said, involved a woman who was bleeding profusely after her girlfriend used a strap-on. The patient's blood pressure "tanked," Bawa said, and she was "close to death." The physician added, "Who would have thought that somebody would go into trauma because of a sex toy?"
Meanwhile, Bawa said that it was relatively common for people to visit the ER while experiencing the kind of sexual dysfunction that would usually be treated by a urologist or gynecologist.
"Sometimes they feel like they're not being taken seriously and have nowhere else to turn," she said.
The doctor left her attending position three years ago to start her own sexual-wellness clinic in Boca Raton, Florida. She said she saw "so many sexual and sex-related injuries" and "cases of sexual dysfunction" in the ER that she "altered the course" of her career to treat people with sexual issues and advise on the best — but least risky — ways to feel satisfied.
Bawa says some people eschew standard sex toys and experiment with everyday things around the house, especially fruits and vegetables.
Bawa said she often treated patients with foreign objects — particularly fruit or vegetables — stuck in orifices such as the vagina or anus.
She said the practice could be dangerous because pesticides or bacteria on the surface of the item could cause irritation. Cuts and abrasions can also occur.
One of her strangest cases involving fruit involved a 20-something woman who said she'd "lost" a banana in her vagina.
"She arrived late at night, which is common for these types of issues," Bawa said.
The doctor put on gloves and a face shield as she used a speculum and a probe to locate the banana.
"I was expecting to see one of those small bananas you find at fancy grocery stores," she said, adding: "But there was absolutely nothing there."
The woman thought for a moment and added that she had peeled it beforehand.
"We think she'd done it awhile ago and the organic matter had been absorbed into her body," Bawa said. "One good thing about peeling the banana was that she didn't introduce any dirt that might have been on the skin."
Bawa said that unlike some patients — including a man with a cucumber stuck in his anus who said he'd slipped and fallen while unloading groceries from his car — the woman was honest about what happened.
"We were grateful for that," Bawa said.
She recommended that people avoid the temptation to use anything other than a regular sex toy for stimulation.
"Sex toys are perfectly safe, but they should be used gently, not aggressively — and with enough lubrication," she added.
It's important to use the right type of vibrator for your anatomy, Bawa said.
People need to be picky about the type of vibrator or butt plug they choose, Bawa said.
She told Insider about a case in which a woman decided to use her small vibrator to stimulate her husband's prostate. She accidentally lost her grasp, and it wound up in his digestive system.
"The couple had lost the vibrator around two days prior, but the man hadn't wanted to come to the ER to admit it," Bawa said.
"So he took laxatives thinking he would poop it out," she added. "But if anything, the contractions moved it up."
A CAT scan showed that the vibrator had made its way to the man's colon.
"It was one of those situations where you look at the scan, and you're sitting next to the tech, and you can't believe what you're looking at," Bawa said.
She said the man's heart rate and blood pressure were stable. Nonetheless, she added, "we couldn't do anything in the ER because it wasn't a situation when we could try and retrieve it."
Instead, he was taken to the operating room. A section of his colon was removed — in a procedure Bawa described as "major abdominal surgery."
She added: "Any time you're cutting open the abdomen and dealing with the colon, you're facing a risk of life-threatening sepsis. It also increased his risk for future abdominal complications."
Bawa said the accident could have been avoided if the couple had used a vibrator designed "especially for the butt." She said, "A vibrator with a wide wing on it will keep it from being pulled right in and traveling."
She added: "A wing — or a ledge — is better than a vibrator that comes with a string. You can lose a string. Many women have lost tampons that way."
Viagra and other drugs for treating erectile dysfunction should be taken with caution, Bawa said.
Bawa said a tell-tale sign that a man who has priapism — an erection lasting more than four hours without sexual stimulation — was his arrival at the ER wearing an unusually long, untucked shirt.
"Some of them try to hide it, but other times, you can see it standing to attention right off the bat," Bawa said.
She said it could be a drug reaction to erectile-dysfunction medications such as Viagra and Cialis. But, she said, it happens more often when the patient exceeds the recommended dose.
"A lot of men don't need the drugs," she said, adding: "They're often perfectly healthy and are just trying to show off to their partner."
She said that oral pills can cause priapism on their own. But the medication Trimex — adminstered through a shot into the penis to increase blood flow and supposedly cause firmer reactions — is more likely to cause the condition, she added.
"When someone takes both an oral pill and also injects Trimex, they have a much higher risk of priapism," the doctor said.
She went on, "Most men think that a never-ending erection is what dreams are made of. But, after a while, they'll start to realize that something is wrong and they need urgent medical help."
People don't read the instructions for stuff they take
She said many people "don't bother to read" the insert before taking the drug or ignore the small print on advertisements.
A man showed up at the ER, she said, with a severe case of priapism that needed immediate attention.
"He arrived at the four-hour mark — the point when you can start getting long-term tissue damage," Bawa said. There was no urologist on call.
Bawa said she injected the man's penis with phenylephrine, a drug that relieves congestion and pressure. But the erection remained. The doctor said she had no choice but to "take an 18-gauge needle and aspirate the blood" from the spongy tissue inside his penis.
"I had to make a slight incision in this case," Bawa added.
She said the worst case of priapism she'd ever seen involved a man who waited 24 hours before visiting the ER.
"He was so embarrassed he told the triage nurse that it was abdominal pain," she said. She said that things had progressed so far, he was later given a penile implant to restore sexual function.
Bawa advises people to look for "safer" alternatives to medications that "promise erections" because they come with "so many side effects," she said.
"There is a time and place for Viagra and Cialis. But some men are popping them like candy," she said.
She advises them to visit their doctor to find out why they have erectile dysfunction in the first place.
"For instance, if you have high blood pressure, and they put you on a beta-blocker medication, it can cause ED," she said. "Maybe you are on an antidepressant causing you to have this. Sometimes the solution is as simple as switching medication."
Bawa said "one of the world's most dangerous sex positions" was the "reverse cowgirl," when one partner straddles their partner with their back to the other's face.
Bawa said that one of the most common sex injuries that she saw at the ER was known — at least in layman's terms — as a "penis fracture."
"The penis doesn't have a bone, but the tissue can feel like it's popped or snapped," she added.
She said the problem could happen during doggy-style or anal sex — when the penis is more likely to slip out compared with the missionary position — but was more common with a partner "riding" on top.
"It can be particularly risky if you're doing the reverse cowgirl," Bawa said.
She added that the maneuver — in which a person "rides" on top with their back to their partner's face — could be tricky.
The penis, she said, has a relatively limited range of movement. If the person on top "gets carried away," she said, they might not realize the damage they're causing.
She advises people to use lubrication.
One night, Bawa said, a 40-something man arrived at the ER seemingly in agony. "He was jumping, panicking, and everybody was telling him to calm down," the doctor said. "He kept saying, 'She broke it!'"
He staggered into the cubicle and told Bawa what happened. "He said, 'She was riding on top of me, having a good old time, and she bent me," the physician said.
The man said that he repeatedly complained and that he heard a "snap" but his girlfriend was oblivious to the sound.
Bawa said there was "swelling, bruising, and a noticeable kink" to the man's penis. She referred him to a urologist so "the tear could be repaired," she added.
"Unfortunately, the penis can become misshapen from these types of injuries," the doctor said. "People may develop a kink long term because plaque or scar tissue builds up."
In extreme cases, she said, patients struggle to have penetrative sex.
"They may need penile implants," she added.
She advises people to use "as much lubrication as possible during any type of sex" — and "attune to their partner's level of comfort," she said.
"You may get caught up in the excitement of your own orgasm," Bawa said. "But it's important to proceed gently and check on the other person."
Read the original article on Insider