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Zippers are leading cause of penile injuries, ER data shows

The study also found that 98 percent of all boys and men who go to the ER with a zipper-related penile injury do not need to be admitted to the hospital.

Gentlemen may want to return to the button fly.

Maybe men should consider returning to the pre-1913 days of the button fly.

For, according to a new study by researchers at the University of California, San Francisco (UCSF), trouser zippers are the most common cause of penile injuries among men in the United States.

Indeed, the researchers’ data suggests that each year about 900 men over the age of 18 seek care in U.S. emergency rooms because their penis has been caught in a zipper.


Actual and estimated numbers

For the study, the researchers used emergency-room data from 100 representative hospitals that participate in the National Electronic Injury Surveillance System (NEISS), which is run by the U.S. Consumer Products Safety Commission. They found that between 2002 and 2010, those 100 hospitals treated 2,695 cases of penile injury, of which 523 (21.6 percent) involved zippers.

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Based on those actual cases, the researchers estimated that emergency rooms in the U.S. treated 17,616 zipper-related penile injuries during the same nine-year period. Of those estimated cases, most (about 9,000) would have involved children and teens aged 18 and older. But men would have experienced almost as many injuries: about 8,000.

In fact, according to these findings, zippers are the leading cause of penile injuries among men who show up at hospital emergency rooms. That’s not true of children, who are slightly more likely to have their penis crushed and bruised by a falling toilet seat than injured by a zipper.

Rarely requires hospitalization

Fortunately, the study also found that 98 percent of all boys and men who go to the ER with a zipper-related penile injury do not need to be admitted to the hospital. Most are treated (a process that often requires separating the zipper from the penis) and sent home. In only two of the 523 actual cases in this study did patients have to undergo an operation to remove the zipper. And only 11 cases involved infections.

Almost all those 11 infections occurred, by the way, because the patients delayed getting to the hospital by two days or more.

The researchers also found that zipper-related injuries rarely involved other genital organs. The second most commonly zipper-damaged organ was the scrotum, but such injuries occurred in less than 1 percent of the study’s cases.

Not surprisingly, zipper-related injuries were extremely rare in women. This study turned up only five such cases. Four involved injuries to the labia. In the fifth, a “zip element” had to be removed from the vagina.

‘Detachment strategies’

The UCSF researchers recommend that parents not put a son into zippered trousers until they are confident that their child has the dexterity and focus to avoid an injury. And they recommend that men wear “form-fitting underwear” to protect themselves from an errant zipper.

The researchers also discuss in cringe-inducing detail a few “detachment strategies” aimed at helping ER physicians treat zipper-related penile injuries. “Cutting the cloth between interlocked dentition is generally adequate,” they write. “When skin is caught within the buckle of the fastener itself, however, removal can be more challenging.”

It may be necessary, they say, for the ER physician to cut “the median bar of the zip with bone or wire cutters to separate the two faceplates and release entrapped skin.” Other techniques include “wedging a screwdriver between the faceplates or promoting separating with torque forces by squeezing the top faceplate with pliers.”

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A last resort: circumcision.

As I said, men may want to return to the button fly.

The study was published last week in the urology journal BJU International.