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Case Reports
. 2021 Aug 20;13(8):e17330.
doi: 10.7759/cureus.17330. eCollection 2021 Aug.

A Curious Case of Rectal Ejaculation

Frank L Ventura  1 , Christopher M Nguyen  1 , Alexander Dang  1 , Michelle Baliss  1 , Lindsay K Sonstein  1
Affiliations
Case Reports

A Curious Case of Rectal Ejaculation

Frank L Ventura et al. Cureus. .

Abstract

Rectal-prostate fistulas are uncommon anatomical connections between the prostatic urethra and rectum that are typically iatrogenic but can also result from other underlying pathology. Here, we present a unique case of a rectal-prostate fistula causing the rectal passage of sperm. A 33-year-old male with a history of illicit drug use presented with five days of testicular pain and a substantial amount of sperm passage from his rectum with ejaculation for the past two years. Computed tomography and voiding cystourethrogram (VCUG) of the pelvis revealed evidence of a rectal-prostate fistula. He was treated with piperacillin-tazobactam, and a surgical fistula repair was performed. Further investigation divulged a three-week comatose state due to cocaine and phencyclidine intoxication two years prior with documentation suggesting a traumatic Foley catheter placement and strong suspicion for premature balloon dilation in the prostatic urethra. Repeat VCUG revealed resolution of the fistula with mildly reduced antegrade ejaculatory volume. Cases secondary to Foley catheter placement have not been previously reported in the literature. Even though urethral catheters have been shown to be effective tools in healthcare, it is crucial for clinicians to recognize the numerous potential complications that oftentimes become an afterthought to many providers. This case not only highlights a rare complication of catheter use but also emphasizes the importance of provider mindfulness when utilizing seemingly benign therapies such as Foley catheters.

Keywords: fistulas; foley catheter; internal medicine; rectourethral fistula; urology.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CT demonstrating gas-filled structure within the posterior aspect of the prostate communicating with the adjacent rectum.
CT: computed tomography
Figure 2
Figure 2. VCUG demonstrating evidence of fistulous communication of the urethra and rectum.
VCUG: voiding cystourethrogram
Figure 3
Figure 3. VCUG demonstrating evidence of fistulous resolution of the urethra and rectum.
VCUG: voiding cystourethrogram
See this image and copyright information in PMC

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