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Thursday, January 15, 2015

Serious misuse of a fork


When it comes to sticking or shoving foreign bodies into the wrong places, the human mind shows boundless creativity. The motives are often difficult to comprehend. While inserting an object into the urethra is a fairly unusual practice, now and then an urological surgeon will be faced with this sort of emergency. The reason given by the patient is usually autoerotic stimulation. Males are 1.7 times more likely to insert something into the urethra than females. Almost all imaginable objects of suitable size have been pulled out of this small orifice: needles, pencils, pens, pen lids, various kinds of wire, safety pins, keys, wire-like objects (telephone cables, rubber tubes, feeding tubes, straws, string), toothbrushes, household batteries, light bulbs, marbles, cotton tip swabs, thermometers, plants and vegetables (carrot, cucumber, beans, hay, bamboo sticks, grass leaves), parts of animals (leeches, squirrel tail, snakes, bones), toys, pieces of latex gloves... The list goes on and on.


In one notable case, a 76-year-old man came to the Emergency Department of the Canberra Hospital in the Garran suburb of Canberra, the capital of Australia, complaining of blood in his urine. After questioning, he admitted that he had inserted a 10 cm steel dining fork into his urethra 12 hours earlier during masturbation. He had no history of psychiatric disorders. 

On examination, the dining utensil was not visible, but palpable within the penis. Pelvic radiography and computerised tomography confirmed the position of the fork, with the prongs pointed towards the urethral opening:


The urethra was not perforated. The fork was extracted with forceps under general anesthesia, with the aid of lignocaine gel. The patient had some mucosal abrasions, but was able to urinate without problems and was discharged home after the procedure. 

The following charming photo shows the fork being pulled out, with ample lubrication:

Images from: Naidu et al. (2013)


Source:

Naidu K, Chung A, Mulcahy M. (2013) An unusual urethral foreign body. Int J Surg Case Rep. 4(11): 1052–1054.

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