A case report on Urethral Polyembolokoilomania from Sri Lanka-psychiatric perspective

Background

: Urethral Polyembolokoilomania is self-insertion of foreign bodies for sexual gratification. Although it is not an infrequent urological emergency, this is the first case reported in available literature from Sri Lanka.

Case presentation

: A 17-year-old male adolescent presented to surgical emergency due to lower abdominal pain and dysuria of 9 days duration. Imaging revealed a foreign body within the bladder. On questioning, he divulged having inserted a piece of wire through the urethra for autoerotic stimulation. He was referred for psychiatric assessment and the foreign body was extracted under general anaesthesia by the genito-urinary team. The psychiatric diagnosis was of Fetishistic Paraphilic Disorder in a patient with borderline IQ. Pharmacotherapy and cognitive behaviour therapy were commenced. The patient defaulted follow-up from the point of discharge from hospital.

Conclusion

: Timely referral of patients with genito-urinary foreign bodies to psychiatric services is important as this presentation is associated with underlying psychiatric disorders. Detection and treatment of underlying psychiatric disorders would mitigate the risk of recurrence.