EP 456 Urethral Polyembolokoilamania in a Female - A Rare and Unusual Case Report
Neha Hande, Santhosh Loganathan, Sanjay RajpalAbstract
Introduction
Foreign body (FB) insertion into the urethra, termed Urethral Polyembolokoilamania, is a rare and unusual presentation. In the UK, reported cases in females are particularly scarce, with the literature limited to only a few case reports involving foreign bodies within the female genitourinary tract.
Case details
A 54-year-old female presented to emergency department with dysuria and haematuria following self-insertion of a crochet hook into her urethra out of curiosity. CT imaging confirmed FB in peritoneal cavity perforating the urinary bladder. A multidisciplinary team comprising urologist and general surgeon performed combined cystoscopy and diagnostic laparoscopy with peritoneal irrigation and drain insertion for safe retrieval.
Discussion
FBs in the urethra and urinary bladder are a rare but challenging urological emergency, often associated with psychiatric illness, substance misuse, and sexual curiosity, and are more common in males than in females. In the UK, approximately 646 cases are reported annually, with many patients presenting repeatedly. Plain radiography is the usual first-line investigation, followed by CT or MRI if required. Although most cases are managed endoscopically, clinicians must maintain a high index of suspicion for urethral or bladder perforation, particularly with sharp or elongated objects. As demonstrated in our case, early imaging is essential to exclude perforation and intraperitoneal migration, which may result in bowel injury and necessitate multidisciplinary surgical management.
Conclusion
This rare emergency requires a multidisciplinary approach to management, especially when complicated by perforation. Psychological assessment and support are essential to reduce the risk of recurrence and ensure holistic care.