Open Access

CASE REPORT

Forensic implications in self-insertion of urethral foreign bodies

Rafael Boscolo-Berto¹, Massimo Iafrate¹, Guido Viel²

1 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Italy
2 Department of Environmental Medicine and Public Health, Section of Legal Medicine and Forensic Pathology, University of Padua, Italy
Address correspondence to Dr. Rafael Boscolo-Berto, Department of Oncological and Surgical Sciences,Urology Clinic, University of Padua, Via Giustiniani 2 – 35100, Padua – Italy

Canadian Journal of Urology 2010, 17(1), 5026-5027.

Abstract

A 54-year-old Caucasian male presented to our emergency department because he had self-inserted a transparent plastic and flexible tube into the urethral meatus, during erotic games. A plain pelvic x-ray film and an abdominal ultrasound were executed to determine the size, shape, orientation and location of the foreign body, and any eventually associated visceral injuries or complications. As results, a long tube of about 50 cm was described entering the urethra and reaching the bladder cavity in which the tube was folded and wrapped, in absence of any visceral complication. The patient underwent an urgent urethrocystoscopy resulting in the retrieval of both the two recognized foreign bodies by an endoscopic basket extraction. To complete the therapeutic approach, we focused also on the possible psychiatric implications of the self-insertion of a foreign body into the urethra, and the initial evaluation reached the diagnosis of depression.
The self introduction of a foreign body into the urinary tract represents an index of potentially harmful "self-destructive" behaviors. If the self-destructive and/or suicidal ideations are not recognized in the clinical setting and the patient subsequently self-inflicts an injury or commits suicide, the urologist may face legal problems related to the lack of diagnosis and treatment, potentially interpretable as a medical error, and thus as a reckless conduct.

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