title: Self-inflicted foreign bodies in lower genitourinary tract in males: Our experience and review of literature.
abstract: OBJECTIVE
  To study retrospectively the frequency, demographic, phenomenological, and psychiatric profile in patients presented with self-insertion of foreign bodies in the lower genitourinary tract in our institute.
  
  
  METHODS
  From January 2009 to 2015, the records of patients admitted with self-insertion of foreign bodies into the lower urinary tract were analyzed retrospectively regarding demographic and phenomenological profile, the mode of presentation, diagnosis, management, complications, and possible contributing factors leading to the event.
  
  
  RESULTS
  Out of 17,978 inpatients, ten patients (0.055%) presented with foreign body insertion in the lower genitourinary tract in last 6 years. Mean age was 28.1 ± 13.9 (7-50) years. Objects used for insertion were varied from seeds, twigs to the electric wire. The contributing factors were lack of partner, misconception about masturbation, and underlying psychiatric illness. The presenting symptoms were pain and swelling of the penis, difficulty in voiding, and skin ulceration. The diagnosis was possible by simple observation in four patients, X-ray kidney, ureter, and bladder, and sonography of the pelvis in six patients. Five patients had endoscopic retrieval of foreign body, 2 had an open, suprapubic cystotomy, urethrotomy was needed in one patient, and forceps removal in two patients. There were no postoperative complications. Psychiatric profile was evaluated in nine patients.
  
  
  CONCLUSIONS
  Foreign body insertion to lower urinary tract was rare. A main cause for insertion of foreign bodies was autoerotism, misconceptions regarding masturbation, and underlying psychiatric illness. In addition to suitable method of surgical removal, counseling and psychiatric evaluation are necessary to prevent recurrences or for early detection of psychiatric problems.
authors.affiliation: Department of Urology, Institute of Nephro Urology, Bengaluru, Karnataka, India.
authors.forename: Nagabhushana
authors.initials: N
authors.lastname: Mahadevappa
authors.affiliation: Department of Urology, Institute of Nephro Urology, Bengaluru, Karnataka, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Kochhar
authors.affiliation: Department of Urology, Institute of Nephro Urology, Bengaluru, Karnataka, India.
authors.forename: Karthikeyan Senguttuvan
authors.initials: KS
authors.lastname: Vilvapathy
authors.affiliation: Department of Urology, Institute of Nephro Urology, Bengaluru, Karnataka, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Dharwadkar
authors.affiliation: Department of Urology, Institute of Nephro Urology, Bengaluru, Karnataka, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Kumar
keywords: Autoerotism; endoscopic retrieval of foreign body; foreign body; lower genitourinary tract; self-inflicted