An extraordinary masturbation instrument: Intravesical electrical wire cable

Abstract

There are several unusual cases in the literature with foreign bodies in bladder or urethra such as candle, needle, thermometer, animal feather, chicken bone, and wooden stick. Because of these foreign bodies there would be several complications. Pain, infection, urosepsis, and hematuria are the usually seen complications in these cases. Cases with electrical wire cables are also rarely seen. Some of the reasons for inserting foreign bodies are masturbation, feeling or presence of urethral obstruction. In this case, we aimed to present a 21-year-old male patient who was admitted to emergency clinic of Keçiören Research and Training Hospital in September 2014 with a urethral foreign body that was extending into the bladder and was used for masturbation.

Resumen

Hay varios casos inusuales en la literatura con cuerpos extraños en la vejiga o en la uretra tales como velas, agujas, termómetros, plumas animales, huesos de pollo, palos de madera etc. Estos objetos pueden general diversas complicaciones; las más comunes son dolor, infecciones, urosepsis o hematuria. Los casos con cables eléctricos se presentan en raras ocasiones. Alguno de los motivos por lo que se insertan cuerpos extraños pueden ser la masturbación o la sensación de obstrucción en la uretra. En esta ocasion se presenta el caso de un paciente varón de 21 años de edad que fue ingresado a la clínica de emergencia de Investigación Keçiören y el Hospital de Formación en septiembre de 2014 con un cuerpo extraño uretral que se extendía hasta la vejiga y se utilizó para la masturbación.

Introduction

There are several unusual cases in the literature with foreign bodies in bladder or urethra such as candle, needle, thermometer, animal feather, chicken bone, and wooden stick.^1,2 Because of these foreign bodies there would be several complications. Pain, infection, urosepsis, and hematuria are the usually seen complications in these cases.^2,3 Cases with electrical wire cables are also rarely seen.³ Some of the reasons for inserting foreign bodies are masturbation, feeling or presence of urethral obstruction.⁴ In this case, we aimed to present a 21-year-old male patient who was admitted to emergency clinic of Keçiören Research and Training Hospital in September 2014 with a urethral foreign body that was extending into the bladder and was used for masturbation.

Case report

In September 2014, a 21-year-old male patient was admitted to emergency clinic of Keçiören Research and Training Hospital with a urethral foreign body that was extending into the bladder. Nearly the half of that urethral foreign body was outside of the urethra and was an electrical wire cable. The patient was routinely inserting the cable into the urethra but at that time the cable was inserted more deeply and the patient had a severe urethral pain. On the X-ray, the electrical wire cable was clearly seen and was extending into the bladder (Fig. 1). Firstly we tried to remove the cable from the extraurethral part but the patient had a severe urethral pain and after that, under spinal anesthesia we cystoscopically removed the wire cable. A gross electrical wire cable was seen after removal (Fig. 2). During cystoscopy, minimal urethral injury was seen and a urethral catheter was inserted. Also there was a urinary tract infection and intravenous antibiotherapy was given to the patient. On postoperative third day, the urethral catheter was taken out and the patient was discharged with oral antibiotherapy. During the routine follow-ups, the uroflowmetry parameters (maximum flow rate, average flow rate, voided volume) of the patient were normal.

Figure 1.

Electrical wire cable is clearly seen on X-ray.

Figure 2.

A gross electrical wire cable was seen after removal.

Discussion

There are a several cases in the literature that were reported with intravesical or intraurethral masturbation instruments. Also there are other reasons for inserting foreign bodies. Mental disorders, and intoxications may also cause this condition.³ Interestingly most of the cases with these extraordinary instruments in the literature, have regular sexual activity and do not have any other diseases.⁴ Urethral foreign bodies may cause some severe infections and injuries.⁴ Iatrogenic cases are also reported in the literature and urologists must be careful for avoiding this condition.² Ultrasonography, X-ray and computerized tomography are the methods used for the diagnosis of foreign bodies.^4–6 For the doubtful cases, cystoscopy may be used.^5,6 There are endoscopic, laparoscopic, percutaneous and open surgical techniques for removing the foreign bodies.^2–5 But for most cases, endoscopic procedures are sufficient,⁴ especially in male patients, where masturbation is very frequent. But using an instrument for masturbation is unusual and there are several psychiatric and psychoanalytic theories about this condition.⁷

There would be some rare cases in daily clinical practice like the case we have presented. Mental conditions of these patients are as important as the physical conditions. Urologists must be careful during the procedures for removing these foreign bodies. And after the procedure, these patients must be consulted to a psychiatrist for the evaluation of mental disorders.

Ethical responsibilities

Protection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that they have followed the protocols of their work center on the publication of patient data.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Conflict of interest

The authors declare that they have no conflict of interest to declare.