Psychiatric Fantasies and Urological Realities: A Singular Case of Self-Inserted Intra-Urethral Foreign Body

Abstract

This case report describes a rare urological emergency involving a 26-year-old schizophrenic patient who presented with acute urinary retention and bleeding after self-inserting a 65 cm metal cable into his urethra. Following sedation, a bladder ultrasound confirmed urinary retention but no foreign bodies in the bladder. Manual removal attempts were unsuccessful, and the patient was taken to the operating room without further imaging. Surgical removal was achieved by making an incision and opening the spongy body to extract the cable. Prophylactic antibiotics were administered, and the urethra was closed over a silicone catheter. Despite recommendations for longer catheter retention, the patient's psychiatric condition required early removal. Postoperative recovery was uneventful, with good outcomes at six months and one year, as confirmed by flexible endoscope evaluations. The patient was referred to psychiatric services for ongoing care. This case highlights the necessity of a multidisciplinary approach in managing urological emergencies, especially when complicated by psychiatric disorders.