The most common complaint is the inability to remove objects that become lodged in the different bodily orifices or genital cavities. When complications arise, the general approach is to present to the emergency room seeking medical care. There is an ever-growing list of objects reportedly used for this purpose, such as clips, screws, pencils, wires, glue containers, or phallus-shaped fruits and vegetables. However, the use of ordinary, household objects for this purpose is still common. A psychological evaluation was performed during his stay, but no evidence of a mental disorder was found.Ĭurrently, a wide range of sexual toys for personal sexual gratification is commercially available. The patient was discharged the following day, and a urethral catheter was left in place for a week. The knotted portion of the wire was cut and removed via the incision, and the remaining wire was manually removed through the urethra. Because of the impossibility of an endoscopic approach, an open suprapubic cystotomy was planned ( Figure 3). No hematuria, pain, or other symptoms were reported. The patient’s only complaint was urinary incontinence owing to the irritation caused by the urethrovesical foreign body.
An abdominal X-ray showed that the wire had become twisted and formed a knot inside the bladder so that it could not be removed by manual extraction ( Figure 2). A physical examination was performed, and both ends of the wire were visible through the urethral opening ( Figure 1). The patient had an unremarkable medical and psychological history.
He was single and had never been married. For no particular reason, he had started the practice 1 year prior to the current incident. The patient reported previous sexual gratification using this practice. The systematic psychiatric evaluation of these patients is controversial.Ī 49-year-old, single, heterosexual male presented to our Emergency Department with a telephone wire stuck in his bladder after he had introduced it through his urethra with masturbatory intentions. We present an unusual case of recreational urethral sounding that required open surgery. The majority of foreign body extractions are managed endoscopically or by performing various maneuvers under local or general anesthesia. The most common reason reported in the medical literature for deliberate urethral insertion is erotic gratification, and the most unexpected complication of this practice is the inability to retrieve the object that becomes lodged in the urethra or the bladder. Sounding is routinely used in urological procedures to dilate strictures or obtain access to the bladder. Urethral sounding is defined as the insertion of an object or liquid into the urethra. KEYWORDS: Recreational urethral sounding, sexual gratification, urethral foreign body, masturbation, sexual behaviorĬORRESPONDENCE: Ignacio Puche-Sanz, MD, Urology Departament, Hospital Universitario Virgen de las Nieves, Av Fuerzas Armadas 2, 18014, Granada, Spain ( )ĬITATION: UroToday Int J. Submitted OctoAccepted for Publication November 19, 2012 Ignacio Puche-Sanz, Fernando Vázquez-Alonso, José Flores-Martín, José Manuel Cózar-Olmo For patients who have complications and seek medical care, a psychological evaluation and advice for safe sexual practices may be useful for better managing this rare clinical situation. Clinicians must be aware of these practices so that they can provide proper care to such patients, apart from the mere resolution of the acute problem. A review of the literature on this issue was made.Ĭonclusion: Some reports claim that certain segments of society engage more readily in recreational sounding and that this practice can lead to complications. No evidence of a psychological disorder was found in our patient. Although the majority of foreign body extractions are managed endoscopically, we describe an unusual case of recreational urethral sounding that required open surgery. We present the case of a middle-aged male who presented to our emergency department with a telephone wire stuck in his bladder after he had introduced it through his urethra with masturbatory intentions. Methods and Results: The aim of this report is to describe a rare complication of this practice. The most unexpected complication of this practice is the inability to retrieve the object after it becomes lodged in the urethra or the bladder. The most common reason reported in the medical literature for deliberate urethral insertion is erotic gratification. Introduction: Urethral sounding is defined as the insertion of an object or liquid into the urethra. Recreational Urethral Sounding with a Telephone Wire: An Unusually Complicated Case Report