Self-inflicted needle in the urethra retrieved endoscopically from the bladder.

he urethra that normally serves as an exit passage for urine also served on rare occasions as an entrance passage for a wide variety of foreign bodies. The most commonly administered objects are different types of pins and pencils.1 More unusual objects included speaker wire, rocks, eye-wear rims, AAA battery, open safety pins, plastic caps, straws, a marble, a cotton-tipped swab and a metal screw.2,3 We reported a case of self-inflicted needle in the urethra that migrated to the prostatic urethra, and removed endoscopically from the bladder without causing significant complications. A 38-year-old male presented to the Emergency Department with a weak urine stream and post-voiding spotting. These symptoms started after self introduction of a needle with a plastic knob at one end into the urethra. He introduced first the plastic nod for the purpose of scratching the urethral wall from an urethral itching sensation felt by the patient. Before introducing the needle, he bent its distal sharp tip to create a 30° angle that would assist him manipulate the knob inside the urethral lumen. He carried out this procedure on frequent occasions for a period of 3 weeks. On one occasion, the distal tip of the needle accidentally slipped completely into the urethra making it impossible for him to retrieve it back. This incident was facilitated by simultaneous use of a herbal gel that was ejected urethrally through the urethral meatus to allow adequate lubrication for scrubbing of the needle hub against the urethral walls. Although, the needle disappeared completely inside the urethra, voiding was mildly affected. He experienced a weak stream with post-voiding spotting in the underwear. Local physical examination revealed mild perineal tenderness in the midline. No palpable mass was felt, and no abnormalities were noted by rectal digital examination. A scout x-ray film of the pelvis showed a rod-like radio-opaque shadow at the level of the prostate that matched with the needle described by the patient. The knob at its proximal end was radiolucent and did not appear in the film (Figure 1). The patient was transferred to the operating theater for cysto-urethroscopy under general anesthesia. The urethra appeared healthy, and we saw the needle floating in the bladder lumen. The needle migrated spontaneously from the T