Progression-free survival determined by the model score group identified a wide range of risk levels for patients with specimen confined prostate cancer. This simple predictive model allows identification of patients at high risk for cancer progression with specimen confined disease who may be targeted for closer surveillance and adjuvant therapy, while those at lower risk may be simply observed.

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A 26-year-old man presented to clinic with a 3-day history of worsening dysuria and decreased urinary output; he had no additional systemic symptoms. He reluctantly disclosed that on the evening before the onset of symptoms, his girlfriend had inserted beads into his urethra as part of their sexual activity that night. The patient did not know the number or type of beads used.On physical examination, the patient was not in distress, his vital signs were normal, and his penis and abdomen were unremarkable. The results of urinalysis were normal. Urine culture was ordered, as were tests for chlamydia and gonorrhea. Because only distal urethral obstruction was considered based on the initial history, a radiograph of the penis was ordered; the radiograph showed no radioopaque foreign bodies.The patient was discharged after being given antibiotic coverage for urinary tract infection, including possible chlamydia and gonorrhea infection, while awaiting test results. The patient was instructed to keep up with oral fluid intake and to return to the clinic the following day if there was no improvement.The following day, the patient returned to the clinic unable to void, despite increased oral fluid intake. The patient had subsequently learned that the beads that had been inserted into his urethra were 1/4 inch spherical, metallic and magnetized beads. After counting them at home, he and his partner discovered that 42 of the beads were missing.A radiograph of his pelvis showed multiple beads in his bladder (Figure 1). The patient was sent to the emergency department of the local hospital for urgent cystoscopy. The urologist used a basket and "three-pronged grasper" to retrieve the beads one at a time via the urethra. The retrieval process took about 1.5 hours. The patient's recovery was uneventful. Possible future complications include urethral stricture. DiscussionMale urethral stimulation is the sexual practice of inserting objects into the distal urethra for the purpose of enhancing sensory response during sexual activity. It has been described as the most common nonmedical reason for the insertion of foreign objects into the male urethra.1 This practice may produce a pleasurable stimulatory effect because of the common innervation of both the urethra and glans penis by the dorsal nerve of the penis, a connection that has been Cases Urinary obstruction from sexual practice involving magnetized beads inserted in the male urethra including medical devices, purpose-built "sex toys" or improvised devices, are inserted into the urethra for sexual stimulation.• There has been a recent cluster of case reports of the urethral insertion of magnetized metal beads, leading to urinary symptoms.• Clinicians should consider the possibility of foreign body obstruction for patients who present with lower urinary tract symptoms.• Foreign bodies may be introduced as far as the urinary bladder.