Friday 19 September 2008

Do not mess with fish 7

And you thought fish were fun!
Boy in bizarre 'fish in penis' accident,
Doctors treating a 14 year old boy from India were shocked to find a 2cm long fish had "slipped" up his penis and into his bladder. The patient, who was admitted to hospital with complaints of pain, dribbling urine and acute urinary retention spanning a 24-hour period, gave an interesting explanation. Details of the case, which was documented in The Internet Journal of Urology, have revealed that the patient claimed that the fish "slipped" into his penis while he was maintaining his aquarium.
The paper's authors, Professor G Vezhaventhan and Professor R Jeyaraman, wrote: "While he was cleaning the fish tank in his house, he was holding a fish in his hand and went to the toilet for passing urine.
"When he was passing urine, the fish slipped from his hand and entered his urethra and then he developed all these symptoms."Mentally he was sound and clinically he was absolutely a normal person with no previous history of any psychiatric illness." RemovalCloser examination using an X-ray failed to show anything, but an ultrasonagram check of the boy's abdomen revealed a full bladder and a small "echogenic object", indicating the presence of a foreign body in the urinary bladder.Vezhaventhan and Jeyaraman then used a technique known as cystourethroscopy to insert a special set of forceps attached down the boy's penis. Unfortunately, the fish was just too slippery to grip, so they resorted to using a rigid ureteroscope with a tool attached that is normally used for removing bladder stones.
Vezhaventhan and Jeyaraman report that a range of self-inflicted foreign bodies have been previously removed from the male genitalia and lower urinary tract. However, the authors claim that the case is the first evidence in the medical literature of fish traveling upstream in the urethra, crossing the external sphincter and entering the urinary bladder."These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. "Most patients were too ashamed to admit they had inserted or applied any object and usually presented when a complication had occurred from the foreign body such as difficulty in voiding, hematuria, pain or swelling, extravasations or abscess formation. Our case is a peculiar one."After the removal of the fish the boy's symptoms disappeared, but he was subsequently sent for psychiatric counseling. For more information see the paper: G. Vezhaventhan, R. Jeyaraman (2007) - Unusual Foreign Body In Urinary Bladder: A Case Report. The Internet Journal of Urology. 2007. Volume 4 Number 2.

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