You’d think somebody repeatedly sticking a needle in your penis would be a little off-putting, but the 21-year-old Iranian apparently thought it would be a grand idea to have Persian script reading borow be salaamat (good luck on your journeys), and the first initial of his girlfriend’s last name (“M”) tattooed onto his little gentleman.

He was left with a permanent semi-erection as a reminder of just how good the idea was.

His case raises a number of questions, not least whether the wish for good luck is directed to the penis or to the man, and if it’s to the penis, where, exactly, is it going? But, medically speaking, how could getting penis ink give make the organ go haywire?

The answer rests in the traditional technique the man subjected himself to. “Handheld needles are used and there is no control of the depth of the needle,” Iranian urologists reported in the most recent Journal of Sexual Medicine. “Henna, ash, and other natural pigments are used by traditional tattooists. They first use their needles to penetrate the skin. Then they apply the coloring material on the perforated skin surface.”

Naturally, this proved painful. After several days, the pain subsided. Soon after it did, though, the man noticed that his nighttime woodies were lasting a long time. A week later, he had a 24/7 priapic erection.

As erectile dysfunction pill commercials constantly remind us, non-sex-related erections lasting longer than four hours are dangerous for penises. The lack of fresh blood flow can starve the spongy tissues of oxygen, destroying them and resulting in impotence.

There are two types of priapism, ischemic and non-ischemic, according to UCLA urologist Dr. Jeffrey Bassett. In a normal erection, blood flows into the penis via arteries, and as pressure builds, the veins leading out are temporarily blocked. In ischemic priapism, the veins don’t open up again.

In non-ischemic priapism, the veins allow blood out of the penile tissue, but too much blood is flowing in via the arteries and the veins can’t keep up. So blood pressure builds. This isn’t as dangerous since fresh blood is coming in all the time, but it can be pretty inconvenient. If it doesn’t resolve, either on its own or with treatment, it can cause damage in some cases.

Bassett once treated a 24-year-old skateboarder who’d traumatized his pelvic area in a skate accident. It tuned out that the injury caused a blood vessel fistula that interfered with normal flow into and out of the penis.

According to the Iranian doctors, this is what happened to the young man. The tattooist punctured too-deep holes that damaged vessels in the penis, resulting in fistulas, and then a pseudoaneurysm, a pooling of blood outside a vessel wall. They recommended he see a specialist to have the blood removed, but he rejected that idea and saw another doctor to have a shunt procedure performed. It didn’t work.

Since the fellow is still able to have sex, and achieve a more-or-less normal erection, he’s rejected any more treatments, even the one his urologists recommended in the first place.

In one of those statements you’d think nobody would actually have to make, the Iranian doctors wrote “based on our unique case, we discourage penile tattooing.”

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