Urethral foreign bodies: a hidden consequence of autoerotic behavior-a case report

Urethral foreign body insertion is a rare clinical condition and is often associated with autoerotic behavior or psychiatric disorders. This case is notable due to the unusual nature of the inserted object-a tree branch-and the absence of previously diagnosed psychiatric illness. It contributes to the literature by emphasizing the clinical, psychological, and procedural considerations required for effective management.

A 24-year-old married Yemeni man presented with a two-day history of dysuria and urinary frequency following the self-insertion of a tree branch into his urethra for sexual stimulation. Physical examination revealed a firm mass in the mid-shaft of the penis. Urinalysis showed microscopic hematuria and pyuria. The diagnosis of a urethral foreign body was confirmed by imaging (ultrasound and KUB X-ray), which revealed a 9 cm rod-like object extending from the mid-penile urethra to the prostatic urethra. Under general anesthesia, cystoscopic removal of the foreign body was performed successfully. A small urethral tear was noted, for which a Foley catheter was inserted and left in place for one week to promote healing. The patient recovered without complications and was discharged the same day.

This case underscores the importance of early diagnosis and minimally invasive management in patients presenting with urethral foreign bodies. It also highlights the need for psychological evaluation to address underlying behavioral causes. Clinicians should maintain a high index of suspicion in similar presentations and ensure a multidisciplinary approach involving both urological and psychological care.