Boondoggled: A Case Report of Arts and Crafts Gone Wrong
DOI:
https://doi.org/10.46570/utjms.vol6-2019-299Keywords:
genitourinary foreign body, bladder, urethra urinary injury, polyembolokoilamania endoscopyAbstract
Self-insertion of foreign bodies into the urinary tract is a not-uncommon urological problem with significant psychosocial implications. A 12-year-old male presented to the ED when his father noted blood in the patient’s urine. During evaluation, the patient admitted to inserting Boondoggle, a plastic arts and crafts string, into his urethra 1 week prior. He admitted to performing this activity on multiple prior occasions. He subsequently developed worsening frequency, urgency, dysuria, hematuria, and suprapubic pain. Bladder ultrasound and KUB were obtained which demonstrated a large amount of hyperdense material coiled in the bladder. He was brought to the OR the following day for removal of the foreign body. After failed attempts at endoscopic retrieval, 34 feet of plastic string was removed via an open approach. The bladder was closed and a foley was left in place. He was discharged on postoperative day 2 on culture specific antibiotics after a successful void trial. Urethral masturbation has been associated with psychiatric disorders, fetishism, and sadomasochistic tendencies. For the urologist, it is critical to recognize the mental health issues portended by urethral foreign body insertion, and take the appropriate steps to address the underlying problem.
References
Athanasopoulos A, Liatsikos EN, Perimenis P, Barbalias GA. Delayed suture intravesical migration as a complication of a Stamey endoscopic bladder neck suspension. Int Urol Nephrol. 2002;34(1):5-7. DOI: https://doi.org/10.1023/A:1021367302431
Bantis A, Sountoulides P, Kalaitzis C, et al. Perforation of the urinary bladder caused by transurethral insertion of a pencil for the purpose of masturbation in a 29-year-old female. Case Rep Med. 2010;2010. DOI: https://doi.org/10.1155/2010/460385
Bartoletti R, Gacci M, Travaglini F, Sarti E, Selli C. Intravesical migration of AMS 800 artificial urinary sphincter and stone formation in a patient who underwent radical prostatectomy. Urol Int. 2000;64(3):167-168. DOI: https://doi.org/10.1159/000030521
Hoscan MB, Kosar A, Gumustas U, Guney M. Intravesical migration of intrauterine device resulting in pregnancy. Int J Urol. 2006;13(3):301-302. DOI: https://doi.org/10.1111/j.1442-2042.2006.01291.x
Kamil A, Cozman C, Aslam A, Nusrat N, Jaffry S. Valentine's day misadventure: Missing vagina for urethra. Urol Case Rep. 2018;18:89-90. DOI: https://doi.org/10.1016/j.eucr.2018.03.015
Scriven JM, Patterson JE. Extraction of an intravesical thermometer using a flexible cystoscope. Br J Urol. 1995;76(6):815. DOI: https://doi.org/10.1111/j.1464-410X.1995.tb07855.x
Stamatiou K, Moschouris H. A rubber tube in the bladder as a complication of autoerotic stimulation of the urethra. Arch Ital Urol Androl. 2016;88(3):239-240. DOI: https://doi.org/10.4081/aiua.2016.3.239
Trehan RK, Haroon A, Memon S, Turner D. Successful removal of a telephone cable, a foreign body through the urethra into the bladder: a case report. J Med Case Rep. 2007;1:153. DOI: https://doi.org/10.1186/1752-1947-1-153
Boscolo-Berto R, Iafrate M, Viel G. Forensic implications in self-insertion of urethral foreign bodies. Can J Urol. 2010;17(1):5026-5027.
Costa G, Di Tonno F, Capodieci S, Laurini L, Casagrande R, Lavelli D. Self-introduction of foreign bodies into the urethra: a multidisciplinary problem. Int Urol Nephrol. 1993;25(1):77-81. DOI: https://doi.org/10.1007/BF02552258
Unruh BT, Nejad SH, Stern TW, Stern TA. Insertion of foreign bodies (polyembolokoilamania): underpinnings and management strategies. Prim Care Companion CNS Disord. 2012;14(1). DOI: https://doi.org/10.4088/PCC.11f01192
van Ophoven A, deKernion JB. Clinical management of foreign bodies of the genitourinary tract. J Urol. 2000;164(2):274-287. DOI: https://doi.org/10.1016/S0022-5347(05)67342-9
Palmer CJ, Houlihan M, Psutka SP, Ellis KA, Vidal P, Hollowell CM. Urethral Foreign Bodies: Clinical Presentation and Management. Urology. 2016;97:257-260. DOI: https://doi.org/10.1016/j.urology.2016.05.045
Rafique M. Intravesical foreign bodies: review and current management strategies. Urol J. 2008;5(4):223-231.
Datta B, Ghosh M, Biswas S. Foreign bodies in urinary bladders. Saudi J Kidney Dis Transpl. 2011;22(2):302-305.
Kenney RD. Adolescent males who insert genitourinary foreign bodies: is psychiatric referral required? Urology. 1988;32(2):127-129. DOI: https://doi.org/10.1016/0090-4295(88)90313-5
Mitchell WM. Self-insertion of urethral foreign bodies. Psychiatr Q. 1968;42(3):479-486. DOI: https://doi.org/10.1007/BF01564386
Wise TN. Urethral manipulation: an unusual paraphilia. J Sex Marital Ther. 1982;8(3):222-227. DOI: https://doi.org/10.1080/00926238208405824
Bodenbach M, Bschleipfer T, Stoschek M, Beckert R, Sparwasser C. [Intravesical migration of a polypropylene mesh implant 3 years after laparoscopic transperitoneal hernioplasty]. Urologe A. 2002;41(4):366-368. DOI: https://doi.org/10.1007/s00120-001-0148-0
Hutton KA, Huddart SN. Percutaneous retrieval of an intravesical foreign body using direct transurethral visualization: a technique applicable to small children. BJU Int. 1999;83(3):337-338. DOI: https://doi.org/10.1046/j.1464-410x.1999.00991.x
Nabi G, Hemal AK, Khaitan A. Endoscopic management of an unusual foreign body in the urinary bladder leading to intractable symptoms. Int Urol Nephrol. 2001;33(2):351-352. DOI: https://doi.org/10.1023/A:1015257528069
Rosenblatt P, Pulliam S, Edwards R, Boyles SH. Suprapubically assisted operative cystoscopy in the management of intravesical TVT synthetic mesh segments. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16(6):509-511. DOI: https://doi.org/10.1007/s00192-004-1282-1
Chan G, Mamut A, Tatzel S, Welk B. An unusual case of polyembolokoilamania: Urethral avulsion from foreign object use during sexual gratification. Can Urol Assoc J. 2016;10(5-6):E181-E183. DOI: https://doi.org/10.5489/cuaj.3778
Rahman NU, Elliott SP, McAninch JW. Self-inflicted male urethral foreign body insertion: endoscopic management and complications. BJU Int. 2004;94(7):1051-1053. DOI: https://doi.org/10.1111/j.1464-410X.2004.05103.x
Wyman A, Kinder RB. Squamous cell carcinoma of the bladder associated with intrapelvic foreign bodies. Br J Urol. 1988;61(5):460. DOI: https://doi.org/10.1111/j.1464-410X.1988.tb06602.x
Byard RW, Eitzen DA, James R. Unusual fatal mechanisms in nonasphyxial autoerotic death. Am J Forensic Med Pathol. 2000;21(1):65-68. DOI: https://doi.org/10.1097/00000433-200003000-00012
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
