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A inclusão do ânus na esfera sexual e a utilização de objetos fálicos para prática auto-erótica, descrito na literatura médica desde o século 16, é freqüente na sociedade moderna. O problema social traz consigo, além do aspecto curioso, o risco de lesões ano-retais traumáticas de graves repercussões. Nesse artigo destacamos esses aspectos, reunindo 20 pacientes do sexo masculino, dos quais 6 (30%) foram atendidos com o objeto retido no reto, e 14 (70%) com lesão ano-retal ocorrida durante a prática erótica e provocada pelo corpo fálico. Dentre os pacientes com lesão ano-retal, 10 (71,4%) estavam com o reto perfurado. As lesões ano-retais foram tratadas cirurgicamente, e 7 desses pacientes (50%) evoluíram com complicações que incluem 2 óbitos (20% entre os que tinham perfuração do reto), o que representa para o grupo todo o índice de 10,5% de mortalidade. A prática do erotismo anal com emprego de objetos fálicos, pelo alto índice de morbi-mortalidade, constitui-se em grave problema médico cirúrgico. Anorectal injuries and colorectal foreign bodies due to anal erotic instrumentation or transanal autoerotism are a common fact of modern homosexual relationship making both a social and surgical problem. Severe anorectal injuries caused by foreign bodies during sexual practice and sexual autostimulation are reported occuring in 20 male patients. These patients are allocated in two different groups. Group 1: patients referred to the hospital with retained like-penis rectal foreign body without anorectal lesions(30 %). Group 2: patients admitted to the hospital with anorectal lesions (70%) due to foreign body inserted into the rectum for sexual stimulation. Among them, 10 patients (71,4%) had rectal perforation. Fifty per cent exhibited several complications following surgical management of injuries. Among patients of the group 2 there were 20% of mortality. We emphasize the severity of such lesions and claim for judicious assessment of those patients

Instrumentação anal erótica: um problema médico-cirúrgico