Abstract
Self-insertion of foreign bodies into the urinary tract is a not-uncommon urological problem with significant psychosocial implications. A 12-year-old male presented to the ED when his father noted blood in the patient’s urine. During evaluation, the patient admitted to inserting Boondoggle, a plastic arts and crafts string, into his urethra 1 week prior. He admitted to performing this activity on multiple prior occasions. He subsequently developed worsening frequency, urgency, dysuria, hematuria, and suprapubic pain. Bladder ultrasound and KUB were obtained which demonstrated a large amount of hyperdense material coiled in the bladder. He was brought to the OR the following day for removal of the foreign body. After failed attempts at endoscopic retrieval, 34 feet of plastic string was removed via an open approach. The bladder was closed and a foley was left in place. He was discharged on postoperative day 2 on culture specific antibiotics after a successful void trial. Urethral masturbation has been associated with psychiatric disorders, fetishism, and sadomasochistic tendencies. For the urologist, it is critical to recognize the mental health issues portended by urethral foreign body insertion, and take the appropriate steps to address the underlying problem.
Highlights
Self-insertion of foreign bodies into the urinary tract is a notuncommon urological problem with significant psychosocial implications
The etiology of genitourinary foreign bodies (GUFB) can range from iatrogenic, the result of penetrating trauma, migration from adjacent organs, or self-insertion [1,2,3,4,5,6,7,8]
Symptoms of GUFB are typically those of the lower urinary tract, including dysuria, hematuria, suprapubic tenderness, or retention [13,14]
Summary
To discuss psychosocial implications of genitourinary foreign body self-insert. Case. The patient admitted to inserting Boondoggle, a plastic arts and crafts string, into his urethra 1 week prior. He admitted to performing this activity on multiple prior occasions because "it feels like sex". On this occasion the string was unable to be retrieved despite multiple extraction attempts with a Q-tip. There was a question of autism spectrum disorder Two months prior he had been in a motor vehicle collision resulting in multiple facial lacerations with significant scarring. The bladder was irrigated thoroughly, closed, and a Foley catheter was left in place He was discharged on postoperative day two on culture specific antibiotics after a success-.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
