Two Young Men Who Complained of Voiding Difficulty After Stuffing Odd Materials Into the Urethra to Obtain Sexual Gratification

Below: (A) The distal segment of a thick and semirigid electrical cable protruding through the meatus. Its tip was tied to prevent further advancement into the urinary bladder. (B) A plain pelvic radiograph revealing a long radio-opaque object, which had twisted multiple times to form a coiled refractory structure in the pelvic cavity.

Below: (A) A plain pelvic radiograph revealing what appeared to be two radio-opaque bars and one circular foreign body in the pelvic cavity of the patient. (B) Two metallic cylinders and one circular magnet stuck together in the urinary bladder are identified using cystoscopy.

The self-insertion of foreign bodies into the urethra to obtain sexual gratification is an uncommon paraphilia and may be complicated by their passage into the urethra and subsequent difficulties in recovering the foreign body. There are two key areas of discussion in relation to this issue: (1) the psychological aspects of the action and (2) the possible treatment options. With careful attention to the patient's history, it is usually possible to identify the foreign body and the time since insertion. In most cases, the individual seeks emergency surgical treatment. Radiological evaluation is necessary to determine the exact size, location, and number of objects. Endoscopic retrieval is usually successful, but open surgical removal is required in some cases. We present two cases of self-insertion of foreign bodies into the urethra.

Via: http://ht.ly/S0fIj 

By: Sungwoo Hong and Hyung Jee Kim

Department of Urology, Dankook University College of Medicine, Cheonan, Korea.