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Self‐inflicted male urethral foreign body insertion: endoscopic management and complications
Author(s) -
Rahman Nadeem U.,
Elliott Sean P.,
McAninch Jack W.
Publication year - 2004
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2004.05103.x
Subject(s) - medicine , dysuria , foreign body , surgery , urethrotomy , urethral stricture , urethra , urinary system
OBJECTIVE To evaluate the cause, diagnosis, management and complications of self‐inserted urethral foreign bodies in men, reviewing a 17‐year experience. PATIENTS AND METHODS From November 1986 to January 2004, 17 men were treated for self‐inflicted urethral foreign bodies; the records were analysed retrospectively for presentation, diagnosis, management and complications. RESULTS In all 17 patients the foreign bodies were clearly palpable. Objects included speaker wire, an AAA battery, open safety pins, a plastic cup, straws, a marble, and a cotton‐tipped swab. The most common symptom was frequency with dysuria, but there was sometimes gross haematuria and urinary retention. The cause for inserting the foreign body varied; psychiatric disorder was the most common, followed by intoxication, and erotic stimulation was the cause in only five patients. All patients had diagnostic imaging; plain pelvic images were sufficient in 14, ultrasonography or computed tomography was needed in three. Endoscopic retrieval was successful in all but one patient, where a perineal urethrotomy was required. The most common complications were mucosal tears and false passages. Urethral strictures were associated with multiple attempts to insert the foreign body. CONCLUSION Self‐inflicted urethral foreign‐body insertion in men is unusual. A radiological evaluation is necessary to determine the exact size, location and number of foreign bodies. Endoscopic retrieval is usually successful, and antibiotic coverage is necessary. A psychiatric evaluation is recommended for all patients, with appropriate medical therapy when indicated. Late manifestation has included urethral stricture disease, and a close follow‐up, albeit difficult in these patients, is desirable.