Multiple Impacted Urethral Metallic Needles and Screws (Foreign Bodies) Associated with Polyembolokoilamania

Abstract

This study aims to present the challenges faced in the management of multiple impacted foreign bodies, needles, and screws from the penile and bulbar urethra. A young man presented with complaint of a hard perineal swelling and passage of metallic nails per urethra. Pelvic radiograph revealed multiple foreign bodies (nails) in the penile and bulbar urethra. Successful cystoscopic removal of 11 foreign bodies comprising four large metallic screws and seven nail-like large sewing needles was done in two sessions. The most prevalent motivation for self-insertion of urethral foreign bodies is autoerotism/psychological impairment. Appropriate surgical technique guided by physical examination/ imaging with endoscopic removal is often successful, depending on the object's physical attributes and morphology while minimizing urothelial trauma and preserving voiding and erectile function. Follow-up cystourethroscopy is important for diagnosing any complications and urothelial injuries.

Foreign body in the male urethra: case report

“…1 Polyembolokoilomania is commonly seen in these individuals. 1,2 It is a psychiatric illness associated with self-insertion of foreign bodies into natural body orifices for sexual gratification, delusional thoughts, and auto eroticism. 2,3 In minors, the most common purpose maybe self-exploration or self-inquisitiveness about the genitalia.…”

“…1,2 It is a psychiatric illness associated with self-insertion of foreign bodies into natural body orifices for sexual gratification, delusional thoughts, and auto eroticism. 2,3 In minors, the most common purpose maybe self-exploration or self-inquisitiveness about the genitalia. Foreign bodies include plastic wires, pins, parts of nail cutters, safety pins, screws, and even small batteries, etc.…”

“…For urethral foreign bodies, an urethrotomy may have to be performed to remove the foreign body whereas an open suprapubic cystostomy may be necessary for removal of foreign bodies in the bladder. 2,5 Complications are usually seen in the open approach which include hematomas, infection, abscess, fistulas, strictures, incontinence, and occasionally erectile disfunction may follow. 5,6 Successful removal of foreign body should always be followed by psychiatric counselling to prevent further the insertion of foreign body in the future.…”

Foreign body urethra misdiagnosed as stricture leading to inadequate management and prolonged treatment duration: a lesson to learn

“…The present case is one of self-insertion of a urethral FB for sexual gratification—polyembolokoilamania 5–7. Singh et al 7 described a case of a 36-year-old man with multiple FBs in the urethra. The removal of FB was done in stages via cystoscopy.…”

An Unusual Case of a Metallic Foreign Body per Urethra

“…[1]. The most prevalent motivation for self-insertion is autoerotism or psychological impairment [2]. The most common presentations are with local pain or swelling, dysuria, haematuria, urinary retention and strangury [3].…”