Endoscopic Removal of A Transversely Impacted Urethral Needle in Schizophrenia
DOI:
https://doi.org/10.37287/ijghr.v8i5.2272Keywords:
foreign body, schizophrenia, self-inserted, urethraAbstract
Self-inflicted urethral foreign body insertion is a rare urological emergency frequently associated with psychiatric disorders and may present significant management challenges, particularly when sharp metallic objects are involved. We report the case of a 44-year-old man with schizophrenia who presented with meatal bleeding and penile pain after self-inserting a needle into the urethra. Clinical evaluation, pelvic radiography, and urethroscopy revealed a 10-cm needle lodged transversely in the bulbomembranous urethra with bilateral mucosal penetration. The foreign body was successfully removed through a minimally invasive endoscopic approach under direct visualization, without fragmentation or the need for open surgery. The patient experienced an uneventful postoperative recovery and was referred for psychiatric follow-up. This case demonstrates that careful endoscopic planning and controlled extraction can facilitate the safe management of sharp urethral foreign bodies even in anatomically challenging locations, while multidisciplinary psychiatric care remains essential to prevent recurrence.
References
Ali, R. N., Irfan, S., Irfan, W., Raza, M. A., Anwaar, A., Karamat, R. I., Akilimali, A., & Arain, I. U. H. (2024). An Act of Auto‐Eroticism: Self‐Urethral Insertion of Sewing Needle by an Old Man—A Case Report With Literature Review. Clinical Case Reports, 12(12), e9682. https://doi.org/10.1002/ccr3.9682
Allo, F. B. R., Hendri, A. Z., Yuri, P., & Alfarizi, Z. Y. (2025). Intravesical foreign bodies in pediatric: A case report highlighting the critical role of psychosocial assessment and intervention. Urology Case Reports, 59, 102979. https://doi.org/10.1016/j.eucr.2025.102979
Crawford, S. B., Lowry, D., & Watts, S. H. (2021). Evaluation and management of urethral foreign bodies and description of a novel ultrasound‐guided catheter‐based extraction technique. JACEP Open, 2(2), e12398. https://doi.org/10.1002/emp2.12398
Fotovat, A., Yavari, S., Ayati, M., Nowroozi, M. R., & Sharifi, L. (2023). A case report of a self-inserted foreign body in the urethra/bladder causing urinary calculus formation, and a review of the literature. Heliyon, 9(3), e14038. https://doi.org/10.1016/j.heliyon.2023.e14038
Gharbia, N., Chakroun, M., Hermi, A., Gharbia, A., Hmouda, S., Ayed, H., Aissa, A., Saadi, A., & Ben Slama, M. R. (2025). Urethral self-insertion of foreign body; a peculiar doorway to a psychiatric diagnosis: A case report. BMC Urology, 25(1), 191. https://doi.org/10.1186/s12894-025-01877-6
Godzisz, M., Kuliniec, I., Mitura, P., Młynarczyk, G., Bar, M., Płaza, P., Sudoł, D., Pogoda, M., & Bar, K. (2025). Self-Inflicted Foreign Bodies in the Lower Urinary Tract Associated with Sexual Activities—A Case Series. Sexes, 6(2), 15. https://doi.org/10.3390/sexes6020015
Haronis, G., Kozyrakis, D., Kallinikas, G., Rodinos, E., Filios, A., Mitiliniou, D., Safioleas, K., Zarkadas, A., Bozios, D., Karmogiannis, A., Konstantinopoulos, V., Konomi, A.-M., & Filios, P. (2025). Insertion of a Foreign Body Into the Urethra: A Report of a Rare Case. Cureus. https://doi.org/10.7759/cureus.78272
Mushtaq, R., Shoib, S., Bhat, M., Shah, T., Mushtaq, S., Hussain, T., & Shah, R. (2014). Unusual foreign body insertion in rectum and vagina in schizophrenic patient. International Journal of Research in Medical Sciences, 2(1), 367. https://doi.org/10.5455/2320-6012.ijrms20140276
Palmer, D. A., Humphrey, J. E., Fredrick, A., Piemonte, T. C., & Libertino, J. A. (2016). Endovascular Removal of Intracardiac Thrombus Prior to Radical Nephrectomy and Inferior Vena Cava Thrombectomy. Urology, 96, 85–86. https://doi.org/10.1016/j.urology.2016.07.020
Perdana, N. R., Shalatin, H., Yulizar, D. R., & Sutapa, H. (2022). Self-Insertion of Urethral Foreign Body: Performing Azayem Procedure for Metal Forceps Removal from Urethra. Open Access Macedonian Journal of Medical Sciences, 10(C), 116–118. https://doi.org/10.3889/oamjms.2022.8032
Temiz, M. Z., Yuruk, E., Teberik, K., & Kandirali, E. (2015). Surgical Removal of an Unrecognized Tapestry Needle from the Urethra. Clinics and Practice, 5(2), 740. https://doi.org/10.4081/cp.2015.740
Thummar, H. G., Vithlani, H. I., Suthar, P. P., John, D. R., Thummar, N., & Chauhan, H. (2016). An Unusual Case of a Metallic Foreign Body per Urethra. Polish Journal of Radiology, 81, 519–521. https://doi.org/10.12659/PJR.899231
Tuncer, H., Karacam, H., & Cam, B. (2021). A Self-Inserted Foreign Body in the Urinary Bladder and Urethra. Cureus. https://doi.org/10.7759/cureus.16322
Vagholkar, K., Prajapat, S., Hamdule, A., Narang, N., & Bhatnagar, I. (2023). Foreign body in the male urethra: Case report. International Surgery Journal, 10(4), 804–806. https://doi.org/10.18203/2349-2902.isj20231004
Wang, X., Wu, X., Liu, W., Du, G., Wang, Y., Wu, R., & Guo, F. (2023). Laparoscopic extraction of a urethral self-inflicted needle from pelvis in a boy: A case report. Frontiers in Pediatrics, 11, 1207247. https://doi.org/10.3389/fped.2023.1207247
Yang, B., Ke, Y., Qiu, A., Wen, L., Xv, X., Liu, X., & Zhang, Y. (2024). Migrating foreign bodies of penis: A case report and literature review. Basic and Clinical Andrology, 34(1), 9. https://doi.org/10.1186/s12610-024-00224-3
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