02/03/2023
A 14 Years Old Boy inserted a USB Cable in his P***s For Sexual Experimentation and to Measure his P***s Length....
A Case of Urethral self-insertion of a USB cable as sexual experimentation....
Case Presentation....
A 14-year-old male patient was transferred to our department from his local hospital following self-insertion of the knotted cable of a USB wire into his urethra in the context of sexual experimentation.
His repeated failed attempts to remove the cable shortly after its insertion resulted in gross haematuria and he presented to the Emergency Department of his local hospital.
After urological assessment, he underwent rigid cystoscopy and optical urethrotomy.
This was unsuccessful due to the proximal knotting of the cable.
A suprapubic catheter was inserted under ultrasound guidance, draining approximately 700 ML of haematuric urine.
This was performed to prevent any episodes of clot or foreign body induced retention.
Following this, the patient was urgently referred and transferred to our department for tertiary evaluation and management.
On admission, he was haemodynamically stable. The two distal ports of the USB wire were found to be protruding from the external urethral meatus whilst the middle part of the knotted wire remained within the urethra.
The patient was an otherwise fit and healthy adolescent with no history of mental health disorders.
Following his request to be examined without his mother, he confessed that he inserted the cable into his urethra to measure the length of his p***s triggered by sexual curiosity.
A plain pelvic radiographic imaging (See image Below) confirmed the exact position and shape of the formatted knot, and the patient was transferred to the theatre....
A longitudinal peno-scrotal incision over the palpable foreign body was made and careful dissection was undertaken through deeper tissues, splitting the bulbospongiosus muscle. The knotted cable was revealed in the proximal aspect of the pe**le urethra and cut from the remainder of the cord.
Both ends of the wire were pulled out successfully through the external urethral meatus (See image Below).
The urethra was closed with interrupted sutures and a urethral catheter was inserted.
His recovery was uneventful, and he was discharged the following day with simple analgesia, oral antibiotics, and the urethral and suprapubic catheters in situ....
A fluoroscopic urethrogram was arranged two weeks post-procedure to assess the urethral healing before removal of the catheters.
No evidence of urine leak or urethral stricture was observed apart from a slight calibre change at the distal bulbar and proximal pe**le urethra, in the position of the recent urethrostomy (See image Below).
The catheter was removed successfully, and ongoing follow-up is required to monitor for any long-term damage....
Dr.Shahid Irfan....
