Preputial advancement flap for delayed urethrocutaneous fistula of the glans following urethral insertion of an ‘AAA’ battery

Published Date: 25th July 2023

Publication Authors: Atayi AA, Omar A, Floyd Jr MS

Abstract

Introduction
Foreign body insertion associated with sexual gratification is known as polyembolokoilomania. Following removal of the foreign body, long-term complications are infrequently seen. Whilst conservative and endoscopic approaches usually suffice, in extreme cases open surgical approaches are required. We describe an unusual case of polyembolokoilomania in a 25-year-old male involving a single ‘AAA’ battery who developed a urethrocutaneous fistula requiring delayed reconstructive surgery.

Case presentation
Following an initial successful open extraction of an ‘AAA’ battery from the mid penile urethra the patient developed a delayed urethrocutaenous fistula of the glans. This was managed using a single stage closure with a preputial graft on its vascular pedicle thereby preserving the foreskin and avoiding a buccal graft. No intra-operative or post-operative complications occurred with a catheter left in situ for 2 weeks. Formal histology confirmed a foreign body type reaction. Following outpatient review successful cosmetic, functional, and sexual outcomes were recorded with questionnaires and medical photography.

Conclusion:
Preputial advancement flap with foreskin preservation for distal urethrocutaenous fistula is a successful method of treating delayed urethrocutaenous fistula of the distal urethra in cases of polyembolokoilomania.

 

Atayi, AA; Omar, AM; Floyd Jr, MS. (2023). Preputial advancement flap for delayed urethrocutaneous fistula of the glans following urethral insertion of an ‘AAA’ battery. Urologia Journal. epub 25 July. [Online]. Available at: https://doi.org/10.1177/03915603231189026 [Accessed 15 December 2023]

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