Numerous cases of intraurethral foreign bodies of great variety and unusual nature have been reported. Such foreign bodies are usually introduced for sexual stimulation and/or during an intoxicated or confused state. Resulting symptoms usually involve the urinary frequency, dysuria, nocturia, hematuria, gross bleeding per urethra, difficulty in voiding, or complete urinary retention.

We present a 61-year-old male with history of Schizophrenia who visited our emergency department complaining that he could not pull out a blue-colored folded metallic hanger inserted in the urethra 2 hours previously. A 5cm of blue-colored tube was seen projecting from the external urethral meatus (Fig.1). There was no urethrorrhagia, bladder globe, or edema of the external genitalia but hematuria. A pelvic X-ray showed a total 15cm folded hanger stuck in the urethra (Fig.2). The patient was under general anesthesia and the hanger was retrieved gently under cystoscopy-guided with hand assisted. After hanger retrieval, cystoscopy examination was performed which showed urethral mucosa injury with debris coating and prostatic urethra diverticulum which may due to previous self-inflicted urethral foreign body induced.

Urethral foreign bodies are at relatively rare occurrence, with several cases reported in the literature to describe presentation and management. Motivations for urethral foreign body insertion included psychiatric illness, autoeroticism, intoxication, and perceived contraception. Patients are often symptomatic at presentation and the intra-urethral trauma may sometimes lead to long-term sequelae. Common complications following foreign body insertion in the urethra included urethral false lumens, membrane laceration, urethritis, and urethral stricture.

We report this case to warrant safety concern with regard to urethral foreign bodies in Taiwan.