Clinical characteristics, treatment, and prognosis of sexual-related rectal foreign bodies: a systematic review and meta-analysis.
Feng Libo, Xia Dong, Liu Yu
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In 30 seconds
This systematic review and meta-analysis examined clinical features, management, and outcomes of sexual-related rectal foreign bodies, drawing on 59 case reports, case series, and cohort studies from 22 countries, with 376 patients. Most patients were male (98.1%), and 61.4% presented more than 24 h after insertion. Transanal extraction was achieved in 73.4% of patients; overall retrieval success was 99.7%. Bowel perforation occurred in 4.7%, stoma creation in 7.2%, and mortality in 0.6%. The authors conclude that transanal extraction succeeds in most cases, with escalation-based management supported by the available evidence.
Key findings
- Most patients were male (98.1%); autoerotic insertion accounted for 92.5% of cases.
- Presentation occurred more than 24 h after insertion in 61.4% of patients, and 98.2% had attempted self-removal.
- Transanal extraction was achieved in 73.4%; overall retrieval success was 99.7%.
- Bowel perforation occurred in 4.7%, stoma creation in 7.2%, and mortality in 0.6%.
Why it matters
The review consolidates reported presentations and outcomes for a potentially urgent surgical problem. It indicates that most cases can be managed with transanal extraction, while also quantifying complications that may require escalation. These findings can inform clinical assessment and management discussions, although the evidence base consists largely of case reports and small series.
What to keep in mind
The evidence comprised case reports, case series, and only four cohort studies; meta-analytic estimates showed substantial heterogeneity for transanal extraction (I2 = 72.5%).