Wednesday, June 24, 2015

Zip injury to the penis: it happens more often than you think!

Zip! And it's done up. The modern zipper provides an easy and convenient means for fastening clothes. An engineer named Gideon Sundback is credited with inventing this ingenious device in 1913. On garments, it was first marketed as a fastener for children’s clothes because of its ease of use. Since then, it has become especially popular for fastening trousers.

Amusingly (or perhaps not), the zipper is not without its dangers. It's not at all uncommon for a boy (or a grown man, for that matter) to have an embarrassing accident while zipping up his fly: a bit of loose skin from the genitals, usually the foreskin, becomes caught between the zipper's teeth.

Between 2002 and 2010, an estimated 17 616 patients presented to US Emergency Departments with trouser zip injuries to the genitals. The penis was almost always the only genital organ involved. Zipper injuries represented nearly one-fifth of all penile injuries. Quite surprisingly, amongst adults, zips were the most frequent cause of penile injuries. In another study, thirty boys, aged 2-12 years, presented with penile zip entrapment to one Pediatric Accident and Emergency Department over a 7 year period. The rate of presentation was one zip entrapment per 4068 new patient attendances. In contrast to previous reports, injuries occurred most commonly whilst the zip was being done up and whilst underpants were being worn.

Luckily, releasing a zip-entrapped prepuce is usually a fairly easy and straightforward procedure. Several nonsurgical techniques have been developed to help patients in this predicament. One of these methods involves inserting the thin blade of a small screwdriver between the outer and inner faceplates of the zip fastener, and then twisting it toward the median bar. This will widen the gap between faceplates, disengaging the foreskin. This simple technique was used in 12 children and was found to be safe, effective and painless. It can be performed by an attending pediatrician even in nonhospital settings. Another quick and nontraumatic approach involves instantly releasing the prepuce by lateral compression of the zipper with pliers. Other reported interventions have ranged from dismantling the zipper with bone or wire cutters (after opening the zipper teeth, the zipper falls apart and can be removed from the foreskin) to circumcision.

So... guys, best watch what you're doing when you're doing up your fly!

Image courtesy of foto76 at


Wyatt JP, Scobie WG. (1994) The management of penile zip entrapment in children. Injury. 25(1):59-60.

Bagga HS, Tasian GE, McGeady J, Blaschko SD, McCulloch CE, McAninch JW, Breyer BN. (2013) Zip-related genital injury. BJU Int. 112(2): E191-4. 

Mishra SC.(2006) Safe and painless manipulation of penile zipper entrapment. Indian Pediatr. 43(3): 252-4

Raveenthiran V. (2007) Releasing of zipper-entrapped foreskin: a novel nonsurgical technique. Pediatr Emerg Care. 23(7):463-4.


  1. Prevention is better than cure (or detachment strategies). Plain Velcro is not the answer. We've developed a solution without teeth that bite and will end zip-related genital injury.

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