PENs in the PENis: a case report and brief review of the literature

According to the literature, there have been reports of introduction of foreign bodies into the urethra predominantly in males, both adults and children. Erotic stimulation, intoxication, assault and psychiatric conditions are the most frequent contributors. A 70-year-old male presented with difficulty in passing urine for one week after having inserted two plastic ballpoint pens into his urethra. The patient had a failed attempt at removal using a rigid cystoscope and biopsy forceps. A Liga-clip applicator allowed successful blind removal of both pens while the patient was under a general anaesthetic. Removal of urethral foreign bodies can be challenging as endoscopic removal may fail, and open or blind procedures may be required. Moreover, complications can be significant. On occasions, improvisations in techniques may be helpful, such as in our patient. A psychiatric review is vital to try and ensure the prevention of repeat incidents.