A team of doctors has documented what they have called "a curious case of rectal ejaculation".
A 33-year-old man sought medical attention after five days of pain in his testicles. This turned out to be the latest in a long line of problems in that general area. For the last two years, he had been passing gas in his urine (pneumaturia), urinating fecal matter (fecaluria), and passing a "substantial amount" of urine and semen from his rectum (there isn't even a fancy medical word for it, that's how rare this is).
All in all, liquids, solids, and gasses were not going out of the passage they traditionally emerge from, long before the pain in his testicles prompted him to finally seek treatment.
The team, who published their case study in the journal Cureus, found the patient to have a swollen testicle. Labs showed signs of a urinary tract infection, while a digital rectal exam showed signs of a problem on his rectal wall.
A CT scan produced a much better look at the problem than can be seen with a finger.
The scan showed a "gas-filled structure". Further tests confirmed the presence of a fistula (an abnormal passageway) between the urethra and rectum, through which the various fluids and solids had been passing. As well as repairing the fistula through surgery, the team looked for possible causes of the problem but ruled out things such as tuberculosis, inflammatory bowel disease, rectal trauma, or penetration.
Upon further investigation, they found that two years prior – around the onset of symptoms – he had been in a three-week coma following cocaine and phencyclidine (PCP) intoxication. During his hospital stay, he was fitted with a Foley catheter, during which the injury was likely caused.
The story, you'll be glad to hear, had a happy ending.
"Repeat VCUG revealed resolution of the fistula and the patient recovered with only mildly reduced antegrade ejaculatory volume over several months," the team wrote.
Ok, we said happy ending, not fairytale ending. The team concluded that while Foley catheters are of importance in patient treatment and management, doctors need to be aware of potential (and rare) complications that can result from their use.
"Physicians should note other potential risks such as urethral injuries," the team write. "This case not only highlights a rare complication of catheter use but also emphasizes the importance of provider mindfulness when utilizing seemingly benign therapies such as Foley catheters."
Though the patient was fine, it's highly recommended that you should seek medical attention should you begin passing wind from your penis, peeing poop or pooping pee, or ejaculating out of your anus.