Ballpoint pen tip as a long-duration intraurethral foreign body: a case report

Abstract

Case description: A 21-year-old man sought medical attention due to self-insertion of a ballpoint pen into his urethra four months earlier, with incomplete removal. He stated he had difficulty urinating, reduced urinary stream caliber, and needed to strain to urinate. Physical examination revealed a palpable solid object inside the distal urethra. Urethral stricture was ruled out through urethrocystography, and mobility of the foreign body was observed. It was removed through meatoplasty and the “milking” technique. Urethrocystoscopy revealed no associated complications and there were none during the six-month follow-up. 
 Relevance: Given that there are very few reports on foreign bodies inside the urethra for long periods of time, the present case provides information on the treatment of such patients.
 Clinical implications: The insertion of a foreign body into the urethra is uncommon and is generally associated with psychiatric disorders or sexually oriented activity. Intraurethral foreign bodies can be associated with the complications of urethral stricture, infections, urolithiasis, and fistulas, among others.
 Conclusions: Diagnosis and treatment were carried out empirically due to lack of evidence in the medical literature, with excellent results.