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, 4 (11), 1052-4

An Unusual Urethral Foreign Body

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An Unusual Urethral Foreign Body

Krishanth Naidu et al. Int J Surg Case Rep.

Abstract

Introduction: Lower urinary tract foreign body insertions have a low incidence. The motives for insertion of a variety of objects are difficult to comprehend. This case warrants discussion given the great management challenge faced by the oddity and infrequency with which a fork is encountered in the penile urethra.

Presentation of case: A 70-year-old man presents to the Emergency Department with a bleeding urethral meatus following self-insertion of a fork into the urethra to achieve sexual gratification. Multiple retrieval methods were contemplated with success achieved via forceps traction and copious lubrication.

Discussion: The presentation of urethral foreign bodies can vary widely, as can the type of object inserted. The most prevalent motivation for self-insertion of urethral foreign bodies is autoerotism. Motivations ought to be explored in light of possible underlying psychological or psychiatric conditions. The most appropriate surgical extraction technique can be guided by physical examination and imaging. Endoscopic removal is often successful, depending on the object's physical attributes and morphology. It is important to arrange appropriate follow-up, as late complications can occur such as urethral strictures.

Conclusion: Psychological and surgical arms encompass the management plan. Foreign body retrieval is determined by its physical attributes and morphology with the aim to minimise urothelial trauma and preserve erectile function. Essentially, endourological extraction serves the primary means of retrieval. Cystourethoscopy is important to diagnose urothelial injuries and to ensure complete removal of foreign bodies following extraction.

Keywords: Cystoscopy; Endoscopy; Foreign bodies; Urethra; Urinary bladder.

Figures

Fig. 1
Fig. 1
Pelvic X-ray depicting radio-opaque foreign body (fork) within penis.
Fig. 2
Fig. 2
Preoperative photograph of penile deformity due to urethral foreign body.
Fig. 3
Fig. 3
Intraoperative photograph showing extraction of a fork per urethra using Rampley forceps.

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