The Practice of ‘Urethral Sounding’ Complicated by Retained Magnetic Beads Within the Bladder and Urethra: Diagnosis and Review of Management

Abstract

Rare disease Background: The emergency treatment of a retained foreign body within the urethra and bladder is an uncommon clinical scenario within adult urology. Beyond the medical field, the placement of an object/s into the urethra is known as 'urethral sounding' and encompasses a sexual practice performed to heighten arousal and pleasure. The medical literature highlights the morbidity associated with this practice, most commonly when the sounding device can no longer be retrieved by the participant. Case Report: A case report involving an 18-year-old male requiring endoscopic retrieval of 60 magnetic metal beads intended for the purpose of urethral sounding. The management was uncomplicated and the patient suffered no longterm complications at follow-up. A brief review of the literature reveals 9 reports since 2013 of magnetic beads retained within the bladder following this autoerotic practice in adults. Conclusions: The insertion of multiple small magnetic beads into the urethra is an inadvisable method for use in the practice of urethral sounding due to the lack of non-operative management options. This is due to the high risk of the magnetic beads forming a magnetized cluster once the chain enters the bladder. All cases assessed report successful management with both minimally invasive and open approaches.

Unusual Complication of Urethral Sounding with a Knitting Needle

“…In conclusion, urethral sounding is an uncommon cause of presentation at clinics, but the number of case reports has increased in recent years [3]. The motivation behind urethral foreign body insertion is most commonly sexual [2]. As reported in the literature, the treatment of choice is the endoscopic retrieval of the self-inserted object.…”

“…Medically, a 'sound' can refer to an instrument that is placed within a narrow passage, often the urethra, for the purpose of exploration and dilatation. However, beyond the field of medicine, urethral sounding exists as a sexual practice and involves the placing of an object or objects into the urethra via the meatus or the injection of liquid along the canal and is most commonly performed to the male urethra [2]. The emergency treatment of a retained foreign body within the urethra and bladder is an uncommon clinical scenario within adult urology.…”

“…The emergency treatment of a retained foreign body within the urethra and bladder is an uncommon clinical scenario within adult urology. Foreign body insertion can cause hematuria secondary to urethral trauma and can increase the risk of infection, urethral stricture, and bladder perforation [2].…”

Intravesical Infection Stones Caused by Magnetic Beads

“…Most intravesical foreign bodies can be removed transurethrally, with minimal access. All the patients reported successful management using both minimally invasive and open approaches [4].…”

“…In a report summarizing urethral bladder foreign bodies caused by magnetic beads, the age ranged from 16 to 50 years, the number of magnetic beads ranged from 25 to 159, and multiple beads were inserted in all cases. Endoscopic removal was performed in seven of the 14 cases, and open removal was performed in the other cases [4]. This study does not mention calculus adhesion to intravesical foreign bodies; therefore, the details are unknown.…”