Foreign bodies in the genitourinary tract, particularly the urethra, pose significant extraction challenges for urologists. A team of specialists detailed one such rare case in Urology Case Reports, involving insulating foam that nearly fully obstructed the urethra and filled the bladder.
Scientific literature documents various urethral foreign body incidents, though they remain uncommon. These can lead to pain, hematuria, urethral trauma, and eventual stricture disease.
In this case study, a 45-year-old man sought emergency care after his partner inserted a long straw connected to an insulating foam canister into his urethra to address erectile dysfunction. The trigger was accidentally pulled, allowing foam to travel through the urethra and into the bladder.
Three weeks later, the patient presented with urinary difficulty and blood in his urine. Abdominal and pelvic CT confirmed the foreign body, prompting immediate surgical intervention.
"Spray foam was initially removed from the bladder and prostatic urethra via cystotomy," the authors noted. "An endoscopic attempt using a basket from the cystotomy failed due to urethral stricture, with tight urethral segments anchoring the foam." Prior self-insertion of objects for sexual gratification likely contributed to the stricture.
A subsequent perineal urethrostomy allowed access through an incision in the perineum, enabling removal of the remaining foam. Additional procedures will be needed to fully restore urethral function.
In their discussion, the physicians highlight that individuals prone to inserting foreign bodies often have underlying mental health issues. "Many are recidivists, warranting psychiatric evaluation to prevent recurrence," they advise. This former homeless patient was not referred, as no repeat incidents occurred post-surgery.
