Batteries Included: A Case of Multiple Self-Inflicted Foreign Bodies in the Lower Genitourinary Tract

Self-insertion of foreign objects into the lower urinary tract is an uncommon presentation with diverse underlying motivations, including psychiatric illness, sexual gratification, intoxication, and perceived contraception. A wide variety of objects may be inserted, leading to varied symptom presentations. We report the case of a 51-year-old male with a history of post-traumatic stress disorder, antisocial personality disorder, and prior self-mutilation, who presented to the ED following self-insertion of multiple foreign objects into the lower urinary tract. CT revealed an AAA battery lodged in his urethra alongside paper clips, with toothpaste caps found within his bladder. Cystoscopy was used to remove the paper clips and to advance the battery into the bladder, allowing the removal of all objects, including the toothpaste caps, via cystoscopy. The patient was prescribed a one-week course of ceftriaxone for a UTI, and his hospital stay was complicated by the need for physical restraint to prevent further self-harm.