A case report on urethrovesical self-insertion of hand sewing needles over four years without symptoms: The hidden dangers of autoerotism

Introduction and clinical importance: Inserting foreign bodies (FBs) into the lower genitourinary tract is an emergency and uncommon medical condition. The materials used for this purpose are batteries, telephone cables, wires and glass. This report highlights a rare case of urethrovesical FBs "hand sewing needles", emphasizing the limited literature on asymptomatic long-term retention and discussing removal strategies that include conservative care, endoscopic retrieval, and surgical intervention based on case complexity. Case presentation: A 14-year-old patient presented to the urology clinic with a complaint of penile trauma and painless hematuria a day ago. Physical examination showed hardness in the urethra and perineum. Ultrasonography and an X-ray pelvis showed the presence of FBs at the level of the prostatic urethra and bladder neck. During follow-up, the patient admitted to inserting several hand sewing needles through his penis for sexual gratification over the past four years. Therefore, the needles were successfully retrieved via cystoscopic intervention. Later, the patient recovered and had normal urination with full discretion. Clinical discussion: Inserting FBs into UT in children is rare, usually occurring at the beginning of puberty. The diagnosis is based on physical examination, urinalysis, and imaging (computed tomography and ultrasonography). Removal should be performed with minimal trauma. Cystoscopy has commonly been the preferred method for this purpose. Conclusion: This paper aims to emphasise the importance of educating patients about the dangerous consequences of these actions and receiving a comprehensive psychological assessment to identify any potential underlying mental health conditions and reduce the risk of recurrence.