In the latest issue of the International Journal of Surgery Case Reports, Doctors Krishanth Naidu, Amanda Chung and Maurice Mulcahy used the unfortunate experience of one Canberra man [Ed. note: Medical pictures at link are NSFW] to illustrate the importance of training doctors to remove self-inserted foreign objects from people's urinary tracts -- and, in this case, they were asked to contend with a nearly 4-inch, 3-tined dessert fork.

The 70-year-old man arrived at the emergency room with visible blood in his urine, but no other apparent symptoms -- that is, until he revealed to doctors that he'd fully inserted a 4-inch dessert fork in his urethra for "autoerotic stimulation." The doctors wrote, "On examination, the fork was not visible, but palpable within the penile urethra." The doctors were able to confirm the man's story with an X-ray (reprinted here), and further examination confirmed that the man had inserted the fork without perforating his urethra.

Doctors used lidocaine gel and forceps to successfully remove the fork without cutting into the man's penis while he was under general anaesthesia, and conducted a post-removal exam that identified only "mucosal abrasions" after it was removed. The patient was sent home after he woke up and urinated "well."

The doctors added:

If one reviews current literature, it is apparent that the human mind is uninhibited let alone creative. The wide array of self-inserted foreign bodies include needles, pencils, ball point pens, pen lids, garden wire, copper wire, speaker wire, safety pins, Allen keys, wire-like objects (telephone cables, rubber tubes, feeding tubes, straws, string), toothbrushes, household batteries, light bulbs, marbles, cotton tip swabs, plastic cups, thermometers, plants and vegetables (carrot, cucumber, beans,hay, bamboo sticks, grass leaves), parts of animals (leeches, squirrel tail, snakes, bones), toys, pieces of latex gloves, blue tack, Intrauterine Contraceptive Devices (IUCD), tampons, pessaries, powders (cocaine), fluids (glue, hot wax).

They additionally note that most patients only go to the ER after "multiple [unsuccessful] removal attempts, which risk urethral injury and foreign body migration." In addition to understanding how to diagnose and remove such objects, the authors believe it is important to assess patients' motives, to prevent a re-occurrence or further injury.

The full report is available here in PDF form. Please note that it contains illustrations of the procedure which some readers may find graphic or NSFW.

["A Man In A Suit With A Fork In His Hand" on Shutterstock]