Foreign body remained in urethra for 12 years: a rare presentation of a common problem with a short review of the literature

Although there are many case reports of foreign bodies in the urethra, the literature represents the tip of the iceberg. Patients usually do not seek medical advice due to embarrassment and present to physicians after several days. We report a case in which a young patient reported to us with periurethral abscess and acute urinary retention. History revealed the insertion of the ink cartridge of a sketch pen into the urethra during masturbation, 12 years before. X-ray and retrograde urethrogram showed multiple radio-opaque foreign bodies in the urethra. We performed incision and drainage, suprapubic catheterization and urethrostomy as an emergency procedure, followed by two-stage urethroplasty. A variety of the objects have been found in the urethra. Self-insertion of foreign bodies into the urethra is usually associated with autoerotic gratifica tion, psychiatric disorders or intoxication. A high degree of suspicion and proper patient history are required to diagnose the condition. The main therapeutic approach is endoscopic, but extensive surgeries are sometimes required. We reviewed the literature thoroughly using PubMed and summarized the causes, diagnoses and management options for this condition. We found our case to be one of the longest standing foreign bodies in the male urethra reported to date.