Rena Malik, MD, is a board-certified urologist specializing in Sexual Medicine, Hormone Health and Urogynecology. With more than 400 million YouTube views and 2.5 million social media followers, she is renowned for dispelling medical misinformation and making complex urological topics accessible. In her next column for Men's Health, Dr. Malik heads into scary territory.

I’LL BE THE first to admit it: Talking about penis injuries is not exactly dinner table conversation. But as a urologist, I've seen firsthand the damage that can be done when things go wrong "down there." And trust me, it's not a risk you want to take. That's why I'm here to give you the lowdown on the most common penis injuries, and how to avoid them.

Penile Fractures

YOU'VE PROBABLY HEARD of that TV show "Sex Sent Me to the ER." While most of those crazy stories are, thankfully, rare, there's one that's more common than you think: penile fractures (1 in 175,000 ER visits).

A penile fracture is exactly what it sounds like—except for there’s no bone to break in the penis. Instead, what breaks is the outer layer of the erectile tissue, known as the tunica albuginea. A penile fracture often happens when an erect penis undergoes a sudden and forceful bending, usually with immediate pain, a popping sound, and visible swelling or bruising. Sometimes, the penis will get swollen and purple, which urologists call an "eggplant deformity" (yes, like the emoji).

The cause of a penile fracture is often a misaligned thrust during vigorous sexual activity. That means the erect penis inadvertently slams against a solid object—usually a pelvic bone. This is most common with positions where it becomes difficult to control rhythm or speed like doggy style, missionary, and reverse cowgirl.

So, what's the takeaway? Be mindful of your rhythm and speed, guys. If you do end up with a penile fracture, don't hesitate. Get to the emergency ASAP. This is a surgical emergency, and prompt treatment can prevent complications like erectile dysfunction or penile curvature.

Penile Strangulation

ANOTHER COMMON MISHAP is penile strangulation, or getting things stuck on the penis. This occurs when you use objects to constrict the penis that aren't specifically designed for that purpose. (Think hair ties, rubber bands, or other everyday items that aren't meant for sex.)

Most times this because a person is sexually curious and they don’t have a safe cock ring or constriction band at home. The issue is these makeshift cock rings can get stuck, causing the penis to swell and making removal even more difficult. If left in place for too long—sometimes just a few hours—they can cut off blood flow, resulting in tissue damage or even gangrene if not treated promptly.

The lesson here? Stick to body-safe products specifically designed for sexual activity, which can be easily removed. And, if you find yourself in a situation where circulation is compromised, get to a hospital right away. Doctors can remove the object safely and before any lasting damage sets in.

(Side note: A different kind of penile strangulation can affect kids. Urologists have seen cases where a child's penis gets entangled in a string, thread, or even a strand of hair. If you're dealing with a fussy or inconsolable child, it's worth checking their genital area to rule this out.)

Penile Skin Injuries

PENILE SKIN INJURIES, specifically zipper injuries, are the most common causes of penile injuries that send people to the emergency room. (Remember that Something about Mary scene?).

In reality, these happen most often to young kids who are distracted when getting dressed, older individuals getting dressed by caretakers, or to adults with neurocognitive dysfunction. To prevent penile skin injuries, consider wearing loose-fitting trousers and underwear, and always zip with care. If you find yourself in a jam—literally—try your best not to freak out and head over to your nearest emergency room.

Other Penile Injuries

SOME PENILE ACCIDENTS can happen in unexpected ways. For example: animal or human bites, car crashes, farm equipment mishaps, and even fireworks accidents (so, be extra cautious on the 4th of July!) can all cause penile injuries. If you're unlucky enough to experience one of these, don't hesitate to get to the ER for a check-up. Your penis is worth it—you only have one.

Fortunately, penile injuries are not common, and I hope most of you reading this will never experience one. Have safe, controlled (but still very pleasurable) sex, use penis-safe sex toys and be careful with zippers!

Your penis will thank you.