Background: Self-inflicted foreign bodies in the urinary bladder are extremely rare sometimes posing a great challenge in the management. Most of these objects are introduced through the urethra for sexual gratification. It is very rare for foreign bodies inserted per the urethra, to reach the bladder, especially in men owing to the anatomy of the urethra.
Case presentation: We report a case of the self-inflicted ball-point pen in the urinary bladder of a male patient during the COVID-19 pandemic lock-down. The uniqueness of this presentation is the patient was able to negotiate the foreign body through the normal curvatures of the urethra to reach the urinary bladder in its entirety without causing any significant injury to the lower urinary tract and its successful endoscopic extraction using nephroscope and the challenges faced during the extraction.
Conclusion: This is the first reported successful endoscopic extraction of a long rigid foreign body from a male urinary bladder. A combined or open procedure is the usual approach for the removal of large bladder foreign bodies. It is now clear to us that the even long rigid bladder foreign bodies in men can be extracted successfully with endoscopy provided adequate endoscopic instruments and armamentarium are available