A man was left needing reconstructive surgery on his penis after being bitten in the genitals by a snake.
The 47-year-old man, of Dutch nationality, was on a safari in South Africa when he was struck by the cobra lurking in the toilet.
According to Urology Case Reports, the man was left in agony for a whole three hours before he was taken to the nearest trauma centre 350km away.
During the gruelling wait to get to hospital, the man experienced a burning sensation in his genitals, as well as a pain that shot all the way up to his upper chest and abdomen.
He also vomited but no neurological symptoms were reported, the report states, while claiming it is the first case of a (Naja annulifera) cobra biting someone's genitals.
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Upon being admitted to hospital, his penis and scrotum "were noted to be swollen, deep purple in color and painful".
"Scrotal necrosis was diagnosed, and he received multiple doses of a non-specific snake venom antiserum and broad-spectrum antibiotics,” according to the medical report.
“The scrotal necrosis was reported to involve the entire fascia (skin to internal spermatic) and was excised with extensive margins. Primary closure was performed, leaving a drain in situ,” Urology Case Reports said.
The man was required hemodialysis due to acute kidney injury before being repatriated to the Netherlands.
Once home, he underwent reconstructive surgery, namely penile shaft debridement
"After a further 6 days, a full-thickness graft was harvested from the groin and placed over the penile defect," the report reads.
"Renal function gradually improved by 2 weeks after repatriation (eGFR, 43 mL/min/1.73m 2 ), at which point he was discharged."
By the time he went in for a follow-up a year later, penile function and sensation had been regained as wounds healed well.
Researchers responsible for writing the report wrote in the conclusion: "Our take home message? Always flush the toilet before sitting down in countries notorious for their snake population!"
