Foreign Body Removal, Rectum

Anorectal foreign bodies are usually inserted transanally for sexual or medicinal purposes. Rectal foreign bodies may also be observed with body packing or stuffing or after prior oral ingestion of the object. Anorectal foreign bodies are more common in men than in women.

Rectal foreign bodies may include such objects as bottles, vibrators, fruit, vegetables, and balls. Cylindrical objects are common. In addition, thermometers may accidentally break while a rectal temperature is being obtained.

Be aware that patients have usually made multiple attempts to remove the object prior to presentation in the emergency department. Patients may create unusual stories to explain how the object became lodged in the rectum.

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Suprapubic Aspiration

Suprapubic aspiration and catheterization is an easily performed emergency department procedure that is associated with minimal complications. Huze and Beeson1 first published this practice in 1956 as an alternative to more traditional methods of obtaining urine for analysis and culture. Their findings suggested that suprapubic catheterization and aspiration was superior to clean-catch or transurethral (via catheterization) collection of bladder urine for bacteriologic study. Since then, the indications for suprapubic catheterization and aspiration have expanded to acute and chronic conditions.

Indication:

Urinary retention (eg, prostate hypertrophy or cancer, gynecologic malignancy, spinal cord injury)
Urinalysis or urine culture in neonates or children younger than 2 years
Phimosis
Chronic infection of the urethra or periurethral glands
Urethral stricture
Urethral trauma

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