A Rare and Unusual Case of Urethral Bleeding

A 46-year-old man presented with urethral trauma following the unusual sexual practice of urethral sounding. He was able to urinate freely and was treated conservatively. He did not require any follow-up. Urethral sounding is uncommon sexual practice, where commonly a metal object is inserted per urethra for gratification. This practice is actively discouraged because of the long-term risks from urethral trauma.

This case highlights a very unusual cause of urethral bleeding and is very rarely encountered, and not, in recent memory, at this teaching hospital urology department.

Although the literature has highlighted the clinical challenges of inserted objects through the urethra and the clinical challenges of removal, this case brings to the forefront a lifestyle choice that has considerable and significant urological morbidity. A significant proportion of people use this practice. It is also a very poorly researched area, with only a handful of relevant literature.

A 46-year-old man presented to the emergency department of urology with urethral bleeding. On questioning, the bleeding was found to be the direct result of the sexual practice of urethral sounding. He was able to pass water freely and a pelvic x-ray did not reveal any retained metal products in his bladder or urethra. There was no indication for catheterisation to tamponade any urethral bleeding and so he was treated conservatively. He was actively discouraged from continuing this practice. A week later, he said that bleeding had completely stopped a few days earlier and that he was asymptomatic. It was decided that there was no need to follow-up the patient with any further investigations such as flexible cystoscopy...

Full article at: http://goo.gl/r8WAbj

By: Tsong Kwong and Tim Larner

Department of Urology, Royal Sussex County Hospital, Brighton, UK

  

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