An unfortunate case published in Urology Case Reports has detailed how a man and his partner accidentally squirted insulation foam up the man's urethra in an attempt to mitigate his erectile dysfunction.
The 45-year-old man showed up to the emergency department with trouble urinating, and blood in his urine when he was able to relieve himself. He and his partner reported to the doctors that they had often inserted various objects into his urethra as an "aid for erectile dysfunction". During one attempt three weeks prior to his admission, his partner had inserted "a straw attached to a can of weatherproofing spray foam" before "inadvertently press[ing] the button deploying the foam".
Following the incident, he had problems urinating, which had progressively gotten worse. A CT scan revealed that the foam had made its way up his urethra, and into his bladder.
The man was taken for a cystotomy, where the team was able to remove the spray foam from his bladder. However, his urethra had been narrowed by scarring – likely from other objects that had been inserted into it – which meant that they were unable to remove the foam from it in this way. In a separate operation – known as a perineal urethrostomy – they went into the urethra through a hole they created in his perineum (aka "taint").
The team were able to retrieve the remaining foam from his urethra, though his urethra will require further operations to repair it in the future. They highlighted that in these cases, mental illness, borderline personality disorder, sexual gratification, and occasionally attempting to gain temporary release from imprisonment often play a role.
"Unfortunately, many patients are repeated offenders and thus psychiatric evaluation to prevent recurrent injury should be considered. Our patient achieved a stable relationship partner, but has been homeless and thus sporadically followed up with suprapubic tube changes," the team wrote.
"He has not been referred to psychiatry as he has not had any repeat episodes since his operation, but would be referred prior to consideration of reconstruction when he achieves a stable living environment."