Urethral Masturbation, Urethral Foreign Body—Review of Cases

Abstract

Intravesical foreign body is a rarity. Studies have reported several items in urinary bladder like gauze pieces, worms, electrical wires, chicken bones, thermometers, pieces of Foley catheter, batteries and snakes. Herein, a case of an electrical wire inserted in male urethra and coiled in the bladder is presented. A seventeen-year-old male presented with history of insertion of electric wire per-urethra. The wire got stuck when he tried to pull it. He had made several unsuccessful attempts to remove it. On examination, the wire was seen protruding from external urethral meatus. An X-ray demonstrated the wire coiled and knotted inside the bladder. Considering high chances of endoscopic treatment failure, suprapubic cystotomy was performed and the wire was removed. The most common reason for self-insertion of a foreign body into male urethra is of erotic or sexual nature. In majority of cases, patient feels guilty and humiliated; therefore, he delays medical help. Many authors advocate psychiatric evaluation of these patients, considering it an indication of self-punishing and impulsive behaviour. However, it is controversial as many of these patients are psychologically normal. The definite management is complete removal of the foreign body by endoscopic or open approach. However, choosing the optimal technique depends upon the patient’s condition, urinary tract injuries and the size, shape and material of foreign body. A self-inflicted foreign body in urethra and bladder is rarity. Endoscopic manipulation is the preferred treatment, and if unsuccessful, open procedures may be necessary.