In my last post, I described the case of a 76-year-old Australian who had inserted a steel dining fork into his penis. The bizarre practice of self-inserting foreign objects into the urethra during masturbation apparently appeals to some people, since an impressive variety of foreign objects gets stuck in urethras and bladders worldwide. A fairly strange case of this sort happened in London: a 62-year-old man was referred to the hospital from a nursing home by staff concerned that he had apparently passed a small household (AAA size) battery while urinating. The patient was in pain with difficulty in passing urine. Relevant in his past medical history was that one year previously a pen lid had been endoscopically removed from his bulbar urethra. He also had right-sided hemiplegia following a cerebrovascular accident 10 years earlier.
An X-ray of the patient's pelvis revealed what appeared to be two dense foreign bodies in his urethra:
Urethroscopy showed two AAA size household batteries lodged there. The surrounding mucosa was very inflamed with areas of necrosis and a rusty appearance suggesting that these batteries had been lodged within his body for a significant period of time. They were successfully removed using an endoscope with grasping forceps. Cystoscopy revealed inflamed-looking bladder mucosa that suggested recurrent urinary tract infections.
Here's an endoscopic view of the batteries, just before removal:
Images from: Bedi et al. (2010)
The patient was catheterized postoperatively and discharged 48 hours later on a two-week course of broad spectrum antibiotics. On further questioning at discharge, he admitted to inserting three AAA sized batteries into his urethra for sexual gratification during masturbation four weeks earlier. Talk about having fun in a nursing home.
Bedi N, El-Husseiny T, Buchholz N, Masood J. (2010) ‘Putting lead in your pencil’: self-insertion of an unusual urethral foreign body for sexual gratification. JRSM Short Rep. 1(2): 18.