No Right Way: Removal of a Pencil Foreign Body From a Male Urethra

Abstract

Foreign body insertion into the urethra is uncommonly encountered in urology practice. Such insertion can result in a myriad of problems including bleeding, infectious sequelae, urinary retention, urethral injury or rupture, and resultant urethral stricture formation. This article describes a case in which an elderly male inserted a pencil into his urethra, which subsequently became lodged and required removal under regional anesthesia in the operating theater. The foreign body resulted in urethral damage in the form of a false passage within the bulbomembranous urethra. The pencil was removed with forceps, followed by undertaking a check rigid ureteroscopy and cystoscopy before placement of a urethral catheter via a guidewire. Postoperatively, the patient developed urinary sepsis requiring an extended course of intravenous antibiotics. The catheter was left in situ for six weeks before removal to allow satisfactory urethral healing.

Keywords: dangerous sexual practices; emergency urology; foreign bodies; foreign body retrieval; urology trauma.

Figure 1. Pelvic x-ray showing a radiopaque pencil extending along the urethral tract, with the tip located proximally near the penile base

Figure 2. Photo showing the pencil after removal from the urethra