Sci heard of today’s Friday Weird Science via the magic of Twitter (follow me if you like. Or don’t. Sometimes I tweet haikus). It’s actually almost too bad, I was GOING to write something not related to penises, but then this came out, and Sci had no choice. When something this outrageous hits the internet…well someone has to blog it.
Forde, et al. “An unusual penpal: case report and literature review of posterior urethral injuries secondary to foreign body insertion” The Canadian Journal of Urology, 2009.
This is a story of what happens when you combine a man, a sexual encounter, a pen, and a complete and thorough ignorance of human anatomy.
To this man’s credit, he presented himself to the ER within 24 hours of the escapade (some people have penile injuries and wait over a month). The man was 57, and had inserted the pen during a sexual encounter (this is something that some people get pleasure out of, though people will also put things up their urethras due to psychiatric issues, or if they’re really drunk and their friends hate them). He never elaborated as to whether or not another person was involved in the encounter.
So he inserts the pen…and apparently inserted it too far. He tried to pull it out and couldn’t. Tried again. No luck. So then, this guy, in his brilliant knowledge of human anatomy, decides to push the pen in MORE, in the hopes of being able to then pull it out of his rectum. This is what makes this case study interesting. Most cases of urethral injury resulting from foreign object insertion occur in the anterior urethra (closer to the tip), but in this case, he pushed it in so far that he had damage to the posterior urethra (closer to the body and bladder).
Here, I would like to take a moment to inform everyone that they should not try this. You don’t HAVE a little connecting tube between your urethra and your rectum, just waiting for the introduction of a ball point pen. If you tried to push the pen through, you would cause extensive damage to a lot of tissues, and possibly some really NASTY complications, before it came out on the other side.
Apparently it was so far in, the doctors couldn’t see anything, and could only FEEL it in the upper part of the scrotum. Pretty high up there, that.
So anyway, here’s where it ended up:
Here you can see the pelvis, and the little white dot at the bottom is the nib of the pen. The rest of it can’t be seen. The pen ended up next to the external urethral sphincter, which surrounds the length of the urethra and controls the flow of urine, and came out through the prostatic fossa, the depression which houses the prostate. Miraculously, the guy didn’t TEAR anything! And (presumably with some painkillers) the doctors were able to remove the pen with some graspers and stone retrieval baskets, which are things that can be inserted in and inflated to create a passage wide enough to free a stuck object (usually a kidney stone or something).
The interesting thing about this case study is that the injury was to the posterior urethra, which is something that usually happens with severe blunt trauma, not something that happens when you stick stuff up your urethra. It takes a truly special guy to want to go the extra distance, and keep on pushing.
Forde JC, Casey RG, & Grainger R (2009). An unusual penpal: case report and literature review of posterior urethral injuries secondary to foreign body insertion. The Canadian journal of urology, 16 (4), 4757-9 PMID: 19671232
