Self-Inserted Urethral Foreign Body Perforating Both the Anterior and Posterior Urethra

Urethral perforation due to a foreign body self-inserted into the urethra is quite rare, although such foreign bodies themselves are not uncommon in clinical urologic practice. Two cases of a self-inserted urethral foreign body leading to anterior urethral perforation have been reported in the English-language literature. However, there are no case reports of urethral perforation or penetration at two sites of urethra due to a self-inserted urethral foreign body. Here, we report the first such case, which occurred in a 66-year-old man and involved a self-inserted metal bar (10 cm long, 3 mm diameter) perforating both the anterior and posterior urethra. As both the proximal and distal ends of the metal bar were outside the urethra in the prostate and scrotum, respectively, the metal bar was surgically removed via the scrotal skin. The patient was treated successfully by suprapubic cystostomy and an indwelling urethral catheter for immediate realignment, with appropriate drainage and antibiotic coverage. The findings of the present case suggest treatment planning based on the appropriate evaluation of urethral foreign bodies is important for the management of patients with urethral perforation due to urethral foreign bodies.