Management of a large chronic calcified urethral foreign body presenting with penile cellulitis

A male patient in his 60s presented with painful penile swelling, sepsis and incomplete bladder emptying. Further questioning revealed a decade-old retained urethral foreign body, later confirmed to be a cable segment. CT confirmed a large linear urethral foreign body in the distal penile urethra with a metallic core with suspected surrounding calcification. Endoscopic extraction was not deemed possible, and a suprapubic catheter was inserted to enable bladder emptying and divert urine away from the infected tissues. A delayed surgical removal of the foreign body was favoured to enable tissue preservation and optimal reconstructive surgery. A ventral urethrotomy with foreign body removal and excision of the fistula tract was performed, followed by delayed urethral closure. This case highlights the importance of recognising risks associated with chronically retained, colonised foreign bodies and the value of perioperative multidisciplinary planning involving Andrology and Genito-Urethral Surgery experts.