• J Am Coll Emerg Physicians Open · Apr 2021

    Evaluation and management of urethral foreign bodies and description of a novel ultrasound-guided catheter-based extraction technique.

    • Scott B Crawford, Drew Lowry, and Susan H Watts.
    • Department of Emergency Medicine Texas Tech University Health Sciences Center El Paso El Paso Texas USA.
    • J Am Coll Emerg Physicians Open. 2021 Apr 1; 2 (2): e12398.

    AbstractThere are numerous reports in the medical literature documenting urethral foreign bodies with nearly all cases found in men and often associated with underlying psychiatric disorders, autoerotic stimulation, and/or intoxication. Patients most commonly presented with localized penile pain, hematuria, dysuria, and occasionally obstruction. Although endoscopic removal by a urologist is often the first-line treatment, this report describes evaluation and management considerations and presents a novel extraction technique that may allow emergency physicians in consultation with urology to perform removal of some unusual urethral foreign bodies in the emergency department. We report a novel extraction technique using a pediatric foley catheter under ultrasound guidance that has been applied during multiple encounters with 2 individuals who have each presented multiple times at a single emergency department (ED) for evaluation because of urethral foreign body insertion. The foreign body materials have ranged from small pieces of rubber to cellophane to styrofoam and most commonly plastic utensils. Urologic extraction may be required in some cases, but ED removal can be considered. A final discussion of the creation of a multidisciplinary care plan to address resource use concerns also is described.© 2021 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.

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