Transperineal approach for penetrating injury of corpus spongiosum and bulbous urethra caused by vesicourethral foreign body: a case report.

BACKGROUND

Vesicourethral foreign bodies are frequently encountered in urological emergency departments; however, cases of penetrating injury to the corpus spongiosum penis and bulbous urethra are rare.

CASE DESCRIPTION: A 64-year-old man presented with difficulty removing a foreign body that he had inserted into his urethra for masturbation. Abdominal computed tomography (CT) revealed a rod-shaped foreign body lodged from the bulbous urethra to the posterior wall of the bladder. Cystoscopy confirmed penetration of the foreign body into the urethral sponge at the bulbous urethra. An attempt was made to remove the foreign body transurethrally, but it was unsuccessful, leading to the establishment of a cystostomy and subsequent hospitalization. Under general anesthesia, the foreign object was removed through a perineal incision, revealing a bamboo skewer with an attached rubber tube. No postoperative complications were noted. Urethrography performed six months postoperatively showed no urethral stricture, and the patient established spontaneous urination without erectile or ejaculatory dysfunction.

CONCLUSIONS

In cases of penetrating urethral injury, where the wound is often sharp, perineal surgery should be considered on par with the transurethral approach, as it does not affect the patient's postoperative quality of life if infection complications are monitored carefully.