自行放入之尿道異物：病例報告

徐志豪、蕭志豪

台北市立萬芳醫院-委託臺北醫學大學辦理；泌尿科

Self-Induced Urethral Foreign Body: A Detailed Case Report

Chih-Hao Hsu, Chih-Hao Hsiao

Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

Introduction:

Placing foreign bodies into the urethra is not a common occurrence in the general population. Patients self-insert foreign bodies for a multitude of reasons such as sexual gratification, secondary gain, and psychiatric illness. From our own experience and what has been reported in the literature, there is a wide variability in the type of objects that patients place into the urethra. Here, we report a male patient with transurethral self-insertion of the egg vibrator into the urethra.

Case description:

A 18-year-old male without underlying disease was suffered from self-inserted the egg vibrator in urethra with pain. The pelvic X-ray was followed and showed a rod like foreign body with wire noted in urethra. Due to failure of removal foreign body conservatively with jelly, we tried cystoscopy first. However, the wire was knotted and failed to retrieve by forceps through cystoscopy. The operation of urethrotomy was then done and the egg vibrator was removed. The wound was then closed layer by layer and silicon Foley was inserted. The patient was discharged with Foley on the next day after operation.

Discussion and conclusions:

Handling urethral foreign bodies is a relatively rare but complex challenge in urology, arising from a range of causes including psychiatric disorders, intoxication, and sexual exploration. Such cases are particularly prevalent among adolescents, driven by curiosity or sexual activities, leading to various complications. Symptoms typically include painful urination, purulent discharge, and bleeding, with larger objects potentially causing urinary blockage and damage to the urinary tract. The standard treatment involves endoscopic retrieval using specialized tools like forceps. However, more complex cases might need surgical intervention, such as open urethrotomy, to remove the object. This medical scenario highlights the need for a multifaceted management approach. Beyond the immediate physical treatment, it's crucial to conduct a thorough assessment including a detailed history, physical examination, and appropriate imaging to accurately determine the size and location of the foreign body for effective removal. Additionally, addressing the broader aspects of patient care is essential, involving infection control, assessment for further injury, monitoring for potential complications, and psychiatric evaluation. This comprehensive strategy ensures not only the resolution of the immediate issue but also the overall well-being and safety of the patient.