不尋常的尿道異物：年輕男性於醉酒後自我插入多顆鋼珠及鋼條之病例報告

黃建翔、余家政、王大齊

高雄榮民總醫院 外科部 泌尿外科

Unusual Urethral Foreign Bodies: Self-Insertion of Multiple Steel Balls and a Steel Rod in a Young Male

Chien-Hsiang Huang, Chia-Cheng Yu, Ta-Chyi Wang

Divisions of Urology, Department of Surgery, Kaohsiung Veterans General Hospital

Introduction

Self-insertion of urethral foreign bodies is a rare urological emergency that may result from sexual curiosity, psychological disorders, or intoxication. Such cases require timely recognition and a tailored management strategy to prevent urethral trauma and infection.

Case Report

A 27-year-old male with a history of allergic rhinitis presented to our emergency department complaining of penile pain, gross hematuria, and dysuria after inserting several steel balls and a steel rod into his urethra while intoxicated. He was unable to remove them by himself. On arrival, his vital signs were stable except for tachycardia (PR 128 bpm). Physical examination revealed a visible metallic rod protruding from the urethral meatus. Laboratory data showed leukocytosis. Pelvic radiograph demonstrated multiple radiopaque round and linear metallic objects along the anterior urethra. Under the impression of urethral foreign bodies, the patient was admitted. Endoscopic removal was successfully performed under anesthesia, and all foreign materials were retrieved without urethral perforation or major complications. He was discharged uneventfully after brief antibiotic therapy and observation.

Discussion

Foreign bodies in the urethra are uncommon but can lead to severe complications such as urethral laceration, false passage formation, infection, and stricture. Imaging plays a crucial role in determining the type, location, and number of objects, guiding the appropriate removal technique. Minimally invasive endoscopic retrieval is the preferred approach whenever feasible, as it minimizes tissue injury and postoperative morbidity. In this case, prompt endoscopic intervention allowed complete removal without the need for open surgery. Psychiatric evaluation is also essential, as recurrent self-insertion behaviors have been reported in patients with underlying mental health or behavioral issues.

Conclusion

Early diagnosis, careful imaging, and minimally invasive removal are key to successful management of urethral foreign bodies. A multidisciplinary approach, including psychiatric assessment, may help prevent recurrence and ensure holistic patient care.