© Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
LETTER TO THE EDITOR
Re: Per urethral insertion of foreign body for erotism:
case reports
JR Khoo1; Gabriel TC Wu1;
Benson KF Yeung, FHKAM (Surgery)2
1 Li Ka Shing Faculty of Medicine, The
University of Hong Kong, Pokfulam, Hong Kong
2 Private Surgeon, Hong Kong
Corresponding author: Dr Benson KF Yeung (dr.bensonyeung@gmail.com)
To the Editor—It was a pleasure to delve
into the detailed article by Mak et al,1
published in the August 2019 issue of the Hong Kong Medical Journal.
The accounts for the diagnosis and treatment of urethral
polyembolokoilamania were comprehensive and interesting. However, to
general practitioners, emergency physicians and general surgeons,
anorectal polyembolokoilamania could well be the more commonly encountered
problem.
We first encountered this disorder in Hong Kong in
1986 when the topic of sex, let alone object-assisted auto-eroticism, was
still taboo. Some patients would rather perish than seek medical help.
Gossiping about the patients’ presentation was, regrettably, commonplace
among the attending healthcare professionals. Unfortunately, the stigma
persists: patients in recent years still display apparent uneasiness when
discussing the condition, despite the more liberal social environment.
We would like to share a few lessons learned over
the decades of dealing with anorectal polyembolokoilamania. First, a
professional and non-judgemental attitude is of utmost importance in
treatment. It ensures that patients are not deterred from seeking
treatment due to stigmatism or potential embarrassment and reduces
physical and emotional complications as a result of delayed treatment.
Second, for the removal of large and slippery
objects from the upper rectum, we found no suitable grasping forceps among
the standardised minor general surgery instruments provided. The best
instrument to use is one available from basic gynaecology instrument sets:
the 9” Teale Vulsellum Forceps. This was discovered when facing great
difficulty in extracting a large silicon rod from a patient’s upper
rectum. Ever since that experience, we have consistently resorted to this
instrument and found that it had expedited subsequent procedures;
including the removal of a large slippery (from lubricant used by the
patient) and activated vibrator.
Author contributions
All authors contributed to the concept, acquisition
and analysis of data, drafting of the article, and critical revision for
important intellectual content.
Conflicts of interest
The authors have no conflicts of interest to
disclose.
Funding/support
The authors received no funding source/grants or
other material support for the study.
Reference
1. Mak CW, Cho CL, Chan WK, Chu RW, Law IC.
Per urethral insertion of foreign body for erotism: case reports. Hong
Kong Med J 2019;25;320-2. Crossref