Abstract
The practice of recreational urethral sounding involves insertion of foreign body in the urethra usually for sexual gratification. We present a case of a 62-year-old male with longstanding recurrent urinary tract infections complicated with Staphylococcus epidermidis bacteremia, discitis, and osteomyelitis at T12-L1 vertebral level associated with left psoas abscess secondary to a retained foreign body inserted into his urethra and urinary bladder. He had extraction of foreign body, cystoscopy, and open cystolithotripsy. He received long-term antibiotics and back surgery resulting in residual chronic back pain. This case illustrates important chronic infectious complications associated with the high-risk sexual practice of urethral sounding.
Highlights
From a medical perspective, a sound is an instrument inserted into bodily passages most commonly the urethra or uterus to gently probe, dilate, or relieve strictures [1,2]
We report the consequences of a chronic intravesical foreign body that led to persistent bacteremia, psoas abscess, and deep spinal infectious complications in a 62-year-old man
The prolonged bacteremia resulted in discitis, osteomyelitis, psoas abscess, and prolonged debilitation from back pain
Summary
A sound is an instrument inserted into bodily passages most commonly the urethra or uterus to gently probe, dilate, or relieve strictures [1,2]. Urethral sounding or urethral "play" refers to the insertion of a foreign body into the urethra often for sexual or erotic purposes [3,4,5] These foreign objects may end up within the urinary bladder. A CT urogram was done for persistent urinary symptoms and it identified a tubular 1.5 cm diameter peripherally calcified 10-12 cm structure with tapered distal ends and intermediate internal attenuation coiled in the urinary bladder (Figure 2) After careful history, he admitted his girlfriend inserted a sex toy shaped like a fishing worm into his urethra few months back, but he did not remember if it was removed. The patient continued to have significant back pain even after a year of follow-up
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