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Dying for it: Bizarre autoerotic deaths (Part 2)

In my previous blog I examined some of the most bizarre autoerotic deaths reported in the medical forensic literature. Here are another five.

Case 1: Autoerotic death by aerosol propellant

Source: Medicine, Science and the Law. Personal details:  32-year old white US man. Single. Computer programmer.

  • Bizarre death event: Found dead in bed with cassette recorder next to him. He was wearing headphones which playing “snorting” horse sounds. There was also a can of aerosol propellant. At the end of the bed was a large painting of a male strapped to the hind legs of a horse who was being anally penetrating by the horse. The horse was ridden by a leather-clad woman. He was also wearing some kind if homemade masturbatory device. His death was recorded as cardio-respiratory failure consistent with aerosol propellant abuse (death by misadventure). Self-administration of the chemical agent to modify the sensations of masturbation. He was covered in dry semen stains.

Case 2: Autoerotic death by clothing

Source: Medicine, Science and the Law. Personal details:  25-year old Japanese male. Single.

  • Bizarre death event: Man found dead in his bed one morning. naked except for clothing wrapping his head and underpants which were pulled down. He was covered in dry semen stains. He had put a black skirt on his face and then pulled a second skirt upside down over his head and turned down the bottom of it. He then put a plastic bag over these two garments followed by a pair of tights. The legs of the tights were used to tie a knot around the bottom of the skirts. He then wrapped a third skirt around all of this. Death was due to suffocation.

Case 3: Autoerotic death by hanging (female)

Source: Handbook of Forensic Pathology. Personal details:  19-year old white female. Single. College student.

  • Bizarre death event: Woman was found dead in her bedroom hanging from the hinge of her closet door dressed as an Oriental “harem girl”. A window sash cord was tied around her body in a complicated fashion and she was also wearing a blindfold and mouth gag (made from the belt of her dressing gown). Next to her lay an underground magazine (this was folded out and showed a bizarre dance involving a clock – the minute hand being a nude male who would make love with the other figure on the hour), a paperback Hitchcock book which explained her fantasy. The paperback contained the story about an Oriental harem master. In this story the harem master provides girls to his lord who stored them by hanging them around his walls on hooks

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Case 4: Autoerotic death by vacuum cleaner

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single. History of heart disease and chronic pancreatitis

  • Bizarre death event: Man was found naked slumped over his vacuum cleaner after a neighbour wondered why the vacuum cleaner had been on continuously for a long time. The man was found leaning against the dining table with his testicles, buttocks and thighs tightly bound with women’s tights. Near the table was a jar of urine, jars of lubricant and a wooden table leg covered in fecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The man basically had a heart attack while engaged in autoerotic activity. The wooden table leg had been used in an attempt to stimulate orgasm via anal penetration. His wife had caught him masturbating with the vacuum cleaner before (they hadn’t had sex for five years). The death was classed as natural rather than accidental.

Case 5: Autoerotic death by hydraulic tractor shovel

Source: Journal of Forensic Sciences. Personal details:  62 year-old US white male. Married. Farmer.

  • Bizarre death event: Found dead in a barn lying on his front pinned under the hydraulic shovel of his tractor. His body was covered with semen stains and there was evidence of masochistic sexual bondage. His clothes were folded neatly away nearby. He was found naked except for a pair of women’s red shoes (with 8 inch heels), knee high stockings and tape duct wrapped around his ankles. Ropes led from his feet to the tractor which when raised would lift his inverted body causing complete suspension. It is not known exactly what happened but it is likely that the engine stalled and he was crushed underneath the tractor shovel. He died of positional asphyxiation by chest compression. This was an atypical autoerotic fatality because he did not purposely use asphyxiation but it did cause his death.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK 

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Byard, R. W. (1994). Autoerotic death—characteristic features and diagnostic difficulties. Journal of Clinical Forensic Medicine, 1(2), 71-78

Cordner, S.M. (1983). An unusual case of sudden death associated with masturbation. Medicine, Science and the Law, 23(1), 54-56

Dietz, P. E., & O’Halloran, R.L. (1993). Autoerotic fatalities with power hydraulics. Journal of Forensic Science, 38(2), 359-364.

Ikeda, N., Harada, A., Umetsu, K., & Suzuki, T. (1988). A case of fatal suffocation during an unusual auto-erotic practice. Medicine, Science and the Law, 28(2), 131-134.

Imami, R. H., & Kemal, M. (1988). Vacuum cleaner use in autoerotic death. American Journal of Forensic Medicine and Pathology, 9(3), 246-248.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.

Hoovers and shakers: Another look at vacuum cleaner sex

In a previous blog I briefly looked at the medical literature relating to penile injuries arising from autoerotic interactions from vacuum cleaners. While researching that blog I also came across other literature that had examined vacuum cleaners being used for sexual purposes that I thought I would make another interesting blog. A number of references in the psychological literature make reference to particular types of people using vacuum cleaners as a source of sexual stimulation for masturbatory purposes. For instance, in a 2005 chapter by Lynne Moxon about sexuality and Asperger Syndrome (i.e., an autism spectrum disorder typically characterized by major difficulties in social interaction and non-verbal communication) noted that among Asperger’s sufferers:

“Lack of awareness of the use of the imagination for sexual fantasy can lead to the use of more physical forms of stimulation, such as the vibration of washing machines or public transport, or the use of vacuum cleaner pipes, holes in chair backs, socks, bottles and more unusual items, such as TV remote controls and golf clubs. Females unaware of the use of sex toys have used deodorant cans, scissors, keys and candles”.

In a 2013 study by Dr. Remigiusz Kijak published in the journal Sexuality and Disability, 133 people (mainly older age teenagers with ages ranging from 17 to 25 years) with mild intellectual disability were surveyed about their sexuality and sexual practices. Dr. Kijak reported that:

“During the studies it has also been determined that 7 % of the studied teenagers stimulate themselves in an untypical manner. The teenagers studied admitted to masturbating with tools, certain objects or to masturbating in a way other than a natural one. The study subjects masturbate using grease, food, furniture and even vacuum cleaners. Such masturbation can be determined as dangerous, mainly due to the fact that it fixes a certain, repeatable chain of strange rituals, often impossible to use in a partner relationship, and may result in a pleasure decrease”. 

As noted in my previous blog on the use of vacuum cleaners as a masturbatory aid, most writings on the topic concern penile injuries that have come to the attention of medics when things go wrong. However, there are a couple of case studies in the forensic literature that have featured vacuum cleaners in autoerotic deaths. In 1988, Dr. R.H. Imami and Dr. M. Kemal published a paper in the American Journal of Forensic Medicine and Pathology about a 57-year old white American male with a history of heart disease and chronic pancreatitis. The man was found naked slumped over his vacuum cleaner after a neighbour wondered why the vacuum cleaner had been on continuously for a long time. The man was found leaning against the dining table with his testicles, buttocks and thighs tightly bound with women’s tights. Near the table was a jar of urine, jars of lubricant and a wooden table leg covered in faecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The autopsy revealed that the man had a heart attack while engaged in the autoerotic activity. The wooden table leg had been used in an attempt to stimulate orgasm via anal penetration. His wife had caught him masturbating with the vacuum cleaner before (and they hadn’t had sex for five years). The death was classes as natural rather than accidental.

In 1994, Dr. Clive Cooke, Dr. Gerard Cadden and Dr. Karin Margolius published a paper concerning four “unusual fatalities where death occurred during autoerotic practice”. Three of the four accidental deaths (electrocution, hanging, and courgette inhalation) involved young to middle-aged men. However, it is the fourth case that is of interest here. This involved an elderly man that (like the previous case) had heart disease. The authors reported that:

“The naked body of this 77[-year] old widower was found in the bathroom of his home…Adjacent to the body, and switched on and working, were a vacuum cleaner and a hair dryer. A pair of men’s underpants was impacted in the hose of the vacuum cleaner. Autopsy examination showed the body of an elderly man of normal build. There was no evident injury; in particular there were no apparent marks of electrical injury. Internal examination showed enlargement of the heart with extensive ischemic fibrous scarring of the thickened left ventricular myocardium. Extensive calcified coronary arteriosclerosis was present, with no thrombosis. There was no significant valvular disease. The lungs were mildly congested and there was benign hypertensive nephrosclerosis. Toxicological analysis was unremarkable. The vacuum cleaner and hair dryer, together with the electric circuitry of the house, were assessed by an electrical inspector and cleared of malfunction. The cause of death was therefore believed to be combined arteriosclerotic and hypertensive heart disease. The scene examination suggested the likelihood that the electrical appliances were being used autoerotically”.

In their discussion of this particular case, Cooke and colleagues noted that sudden autoerotic deaths due to a natural disease process (e.g., heart disease) have seldom been reported in the forensic literature. To their knowledge, only two previous case reports had been published prior to their own study – both males who after autopsy:

“…showed significant arteriosclerotic cardiovascular disease. One was the case of a 61 [-year] old man who died whilst bound with chain restraints; a vibrator was nearby [Hazelwood, Dietz & Burgess, 1981]. The second case was of a 57 [-year] old man whose body was found naked alongside a running vacuum cleaner; the testicles, thighs and buttocks were tightly bound with pantyhose [Imami & Kemal, 1988]. Such deaths are probably less frequent than sudden natural death associated with heterosexual or homosexual activity, particularly if with a novel partner [Malik, 1979]”.

Finally, the only other vacuum cleaner-related autoerotic death I located in the forensic literature was a 2005 case study report by Dr. Andrew Hitchcock and Dr. Roger Start in the Journal of Clinical Forensic Medicine. This was actually a case of hypoxyphilia where the device built to cut off the oxygen supply involved a vacuum cleaner. More specifically, the paper reported:

“A case is reported of a 36-year-old man who died following occlusive entrapment within a device for the purpose of hypoxyphilic gratification. The device was constructed in his own home using instructions found on his home computer down-loaded from the Internet. The device comprised a tough plastic cocoon large enough to accommodate an adult human and incorporating a system of plastic piping connected to a household vacuum cleaner for the evacuation of air within the cocoon. The mechanism of death was thought to be traumatic asphyxia after examination of the deceased and re-construction of the apparatus with the body in situ”.

The prevalence of autoerotic acts involving the use of vacuum cleaners is unknown as only those cases that result in serious genital injury and/or death come to the attention of medics and/or forensic scientists. As noted in my previous blog, the number of cases that are being reported is on the decrease but this may be because the topic is less novel than it used to be and may not be seen by journal editors as worthy of publication.

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Benson, R. (1985). Vacuum cleaner injury to penis: A common urologic problem? Urology, 25(1), 41-44.

Citron, N.D., & Wade, P.J. (1980). Penile injuries from vacuum cleaners. British Medical Journal, 281(6232), 26.

Cooke, C.T., Cadden, G.A., & Margolius, K.A. (1994). Autoerotic deaths: Four cases. Pathology, 26(3), 276-280.

Hazelwood, R.R., Dietz, P. E., & Burgess, A.W. (1981). The investigation of autoerotic fatalities. Journal of Police Science & Administration, 9, 404-411.

Hitchcock, A., & Start, R.D. (2005). Fatal traumatic asphyxia in a middle-aged man in association with entrapment associated hypoxyphilia. Journal of Clinical Forensic Medicine, 12, 320-325.

Imami, R. H., & Kemal, M. (1988). Vacuum cleaner use in autoerotic death. American Journal of Forensic Medicine and Pathology, 9, 246-248.

Kijak, R. (2013). The sexuality of adults with intellectual disability in Poland. Sexuality and Disability, 31(2), 109-123.

Klintschar, M., Grabuschnigg, P., & Beham, A. (1998). Death from electrocution during autoerotic practice: Case report and review of the literature. American Journal of Forensic Medicine and Pathology, 19, 190-193.

Malik, M. O. (1979). Sudden coronary deaths associated with sexual activity. Journal of Forensic Sciences, 24, 216-220.

Moxon, L. (2005). Diagnosis, disclosure and self-confidence in sexuality and relationships. In D. Murray (Ed.), Coming out Asperger: Diagnosis, Disclosure and Self-Confidence (pp. 214-229). London: Jessica Kingsley Publishers.

Rossi, M., Cascini, F., & Torcigliani, S. (1991). [Penile injuries caused by masturbation with a vacuum cleaner. Description of a case and review of the literature]. Minerva Urologica e Nefrologica, 44(1), 43-45.

Hoover damn! A brief look at sexual injury by vacuum cleaners

While researching an article on bizarre sexual injuries, I recently came across a paper on penile skin loss in a 2014 issue of Surgical Science by a group of plastic surgeons led by Dr. Adel Tolba. In the paper, the authors noted that penile skin loss “can result from traction by mechanical devices, such as farm or industrial machinery, or by suction devices, such as vacuum cleaners”. This got me wondering to what extent sexual injuries caused by vacuum cleaners had been reported in the medical literature. The earliest paper that I could on the topic was published in a 1960 issue of the British Medical Journal by Dr. Miles Fox and Dr. E.L. Barrett, and simply entitled ‘Vacuum cleaner injury of the penis’. They reported three cases of similar looking penile injuries caused by three British men seeking sexual stimulation from a vacuum cleaner.

  • Case 1: “A widower aged 57 attended hospital…because of penile lacerations…Returning from having a few drinks in a public-house and seeking erotic satisfaction, he introduced his penis into the end of a vacuum cleaner tube and switched on the machine. However, pain soon caused him to stop, and then he found his penis was congested and bleeding. On examination the glans penis was extensively lacerated, the lacerations appearing almost ‘explosive’ in nature. The urethra was not involved. The lacerations were sutured with catgut, and a soft rubber catheter was introduced for several days. Recovery was uneventful”.
  • Case 2: “A 28-year-old bachelor attended hospital…with similar extensive lacerations of the glans penis extending into the external urethral meatus. The prepuce was also lacerated. He had produced the injuries in exactly the same manner as the [patient in Case 1 above]. Circumcision was performed, the lacerations of the glans were sutured with catgut, and a self-retaining urethral catheter was introduced. Healing was satisfactory without any sign of stricture”.
  • Case 3: “A widower aged 75 [years] attended hospital…in great mental distress and complaining of pain, swelling, and laceration of the penis. He stated that while cleaning the stairs his penis had accidentally slipped into the end of a Hoover ‘Dustette’ vacuum cleaner. However he then attempted to obtain erotic stimulation by switching the motor on and off…The lacerations were not extensive enough to warrant suture or circumcision, and healed satisfactorily in two weeks”

Fox and Barrett described the use of masturbation via a vacuum cleaner as “rather ingenious but had disastrous results”. They concluded that no previous cases of penile injury by vacuum cleaner had ever previously been reported in the medical literature.

In 1973, Dr. Robert Zufall published a letter in the Journal of the American Medical Association (JAMA) describing a penile laceration caused by a vacuum cleaner. Dr. Zufall did not mention any sexual motive for the injury but a follow-up letter in the JAMA by Dr. Rodney Mannion responded that:

“[Dr. Zufall] appears to regard these injuries as possibly accidental. We in urology tend to believe that they occur as a form of masturbation. I have had a patient with this injury who admits to this practice, and a number of urologists also have had similar cases as we discovered at a meeting of the New England Section of the American Urologists Association in October 1972. Many of the urologists present knew of this injury”.

In 1980, another four case studies of penile sexual injuries caused by vacuum cleaners were published in the British Medical Journal by Dr. N. Citron and Dr. P. Wade:

  • Case 1: “A 60-year-old man said that he was changing the plug of his 
Hoover Dustette vacuum cleaner in the nude while his wife was out shopping. 
It ‘turned itself on’ and caught his penis, causing tears around the external 
meatus and deeply lacerating the side of the glans. The external meatus was 
reconstructed and the multiple lacerations of the glans repaired with catgut. 
The final result was some scarring of the glans, but the foreskin moved easily 
over it”.
  • Case 2: “A 65-year-old railway signalman was in his signal box when he 
bent down to pick up his tools and ‘caught his penis in a Hoover Dustette, 
which happened to be switched on’. He suffered extensive lacerations to the 
glans, which were repaired with catgut with a good result”.
  • Case 3: “A 49-year-old man was vacuuming his friend’s staircase in a loose-fitting dressing gown, when, intending to switch the machine off, he 
leaned across to reach the plug: ‘at that moment his dressing gown became 
undone and his penis was sucked into the vacuum cleaner’. Because he had a 
phimosis [a condition in males where the foreskin cannot be fully retracted over the glans penis] he suffered multiple lacerations to the foreskin as well as 
lacerations to the distal part of the shaft of the penis, including the 
external meatus. His wounds were repaired with catgut and the phimosis 
reduced with a dorsal slit”.
  • Case 4: “This patient was aged 68 [years], and no history was available except 
that the injury was caused by a vacuum cleaner. The injury extended through 
the corpora cavernosa and the corpus spongiosum and caused complete division 
of the urethra proximal to the corona. A two-stage urethroplasty was 
performed, and the final result was satisfactory”.

Citron and Wade then noted that (apart from the patient with phimosis) that the injuries were predominantly lacerations to the [penile] glans, “presumably because the 
foreskin was retracted at the time”. The final case was the most serious and required significant surgery to repair the damage. It was also noted that 
at least two of the penile injuries were caused by a Hoover Dustette (as was one in the 1960 paper), which 
the authors noted had fan blades of about six inches from the inlet. They concluded that the “patients may 
well have thought that the penis would be clear of the fan but were driven to 
new lengths by the novelty of the experience and came to grief”. In response to this paper, Dr. J.T. Hill wrote a letter to the British Medical Journal and noted that:

“In a series of 57 penile injuries reported at the annual meeting of the British Association of Urological Surgeons in June 1980, I reported three patients with this condition. Their ages were, typically, 66, 55, and 60 years. They had suffered degloving injuries and two patients required suturing of multiple lacerations and one required split skin grafting. All three patients underwent urethral catheterization for urinary retention”.

In a 1979 issue of European Urology, Dr. U. Wenderoth and Dr. U. Jonas examined 48 masturbation injuries. Of these, they reported that 12 comprised ‘foreign bodies’ introduced into the urethra and urinary bladder while the other 36 cases comprised ‘vacuum cleaner injuries’ to the penis. In 1984, Dr. Jack McAninch and his colleagues published a paper in the Journal of Trauma-Injury Infection and Critical Care that examined major injuries to the testicles, penis, and genital skin from trauma in 62 of their patients over a six-year period (1977 to 1983). They reported seven suction-end vacuum cleaner injuries in their sample.

In 1985, Dr. Ralph Benson wrote a paper in the journal Urology asking whether vacuum cleaner injuries to the penis were a common urologic problem. He presented five cases studies of such penile injuries (including a case of a man that had lost the glans of his penis). He concluded that contrary to apparent public appreciation, injury due to this form of autostimulation may not be unusual”.

An Italian paper Rossi et al in a 1991 issue of Minerva Urologica e Nefrologica reported the case of penile injury caused by masturbating using a vacuum cleaner. The vacuum cleaner caused skin lesions and urethral lacerations (but were successfully treated). The authors stressed “the extreme rarity of the case”. Since then academic papers in the topic appear to have dried up somewhat.

In 1998, a news story made worldwide headlines when a 51-year-old man from Long Branch (New Jersey, USA) cut off half an inch of his penis (and nearly bled to death) after masturbating with a
vacuum cleaner. He first told legal and medical authorities that he had been stabbed in his penis by someone as he slept. However, it later became apparent that he was trying to gain sexual pleasure from the vacuum cleaner’s suction. However, he hadn’t realised there was a blade that pushed dust into the vacuum cleaner’s bag. Fortunately, medics at Monmouth Medical Center stopped the bleeding (saving the man’s life) but
were unable to reattach the severed part of his penis. As far as I am aware, this case was never reported in the medical literature and only in the popular press.

The most recent (possible) case that I have come across was a 2005 case study published in a German journal by Dr. J. Falk and his colleagues. They reported the case of a 61-year-old man that was admitted to hospital with a partially severed penis. The authors reported:

“The head of the penis (glans) had been completely severed, and the skin of the shaft and the corpora cavernosa had been ripped open. In the hospital the patient reported that his penis got caught in the hose attachment of an old Kobold vacuum cleaner that he was using to inflate an air mattress. He later made contradictory statements in his report to the insurance company, so we were asked to reconstruct the circumstances of the accident. The literature available to us only makes clinical observations about similar accidents, always with the assumption that the vacuum cleaner was used during masturbation or in order to achieve an erection. According to our reconstruction of the accident and an investigation of the vacuum cleaner attachment, however, we could not rule out the possibility of a household accident as described by the patient”.

The lack of more recent (and definitive) reports about masturbatory penile injuries caused by vacuum cleaners in the medical literature suggests they are either less commonplace than they used to be and/or there are as many as there have ever have been over the last few decades but are not as journal-worthy (as they are no longer novel).

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Benson, R. (1985). Vacuum cleaner injury to penis: A common urologic problem? Urology, 25(1), 41-44.

Citron, N.D., & Wade, P.J. (1980). Penile injuries from vacuum cleaners. British Medical Journal, 281(6232), 26.

Falk, J., Riepert, T., & Rothschild, M. A. (2005). [Traumatic partial amputation of a penis – A reconstruction of the circumstances of the accident]. Versicherungsmedizin/herausgegeben von Verband der Lebensversicherungs-Unternehmen eV und Verband der Privaten Krankenversicherung eV, 57(1), 17-19

Fox, M., & Barrett, E.L. (1960). ‘Vacuum cleaner injury’ of the penis. British Medical Journal, 1(5190),1942.

Hill, J. T. (1980). Penile injuries from vacuum cleaners. British Medical Journal, 281(6238), 519.

Mannion, R.A. (1973). Penile Laceration. Journal of the American Medical Association, 224, 1763-1763

McAninch, J.W., Kahn, R.I., Jeffrey, R.B., Laing, F.C., & Krieger, M.J. (1984). Major traumatic and septic genital injuries. Journal of Trauma-Injury, Infection, and Critical Care, 24, 291-298.

Morey, A.F., & Rozanski, T. A. (2007). Genital and lower urinary tract trauma. Campbell-Walsh Urology, 3, 49-50.

Nolan, J. (1998). Love story with a cutting edge. Philly.com, may 14. Located at: http://articles.philly.com/1998-05-14/news/25742370_1_vacuum-love-story-unidentified-man

Pryor, J. P., Hill, J. T., Packham, D. A., & Yates‐Bell, A. J. (1981). Penile injuries with particular reference to injury to the erectile tissue. British Journal of Urology, 53(1), 42-46.

Rossi, M., Cascini, F., & Torcigliani, S. (1991). [Penile injuries caused by masturbation with a vacuum cleaner. Description of a case and review of the literature]. Minerva Urologica e Nefrologica, 44(1), 43-45.

Tolba, A. M., Azab, A. A. H., Nasr, M. A., & Salah, E. (2014). Dartos fascio-myo-cutaneous flap for penile skin loss: A simple flap with an immense potential. Surgical Science, 5, 6-9.

Wenderoth, U., & Jonas, U. (1979). Curiosity in urology? Masturbation injuries. European Urology, 6, 312-313.

Zufall, R. (1973). Laceration of penis from hand vacuum cleaner. Journal of the American Medical Association, 224, 630.