Man Ejaculates From Anus, Urinates Feces for Two Years Before Seeking Help

Doctors have published a case study detailing a man who started ejaculating from his rectum after a previous medical procedure caused complications.

The man, aged 33, turned up for medical care after experiencing pain in one of his testicles for the previous five days. He also said he had been passing a "substantial" amount of urine and sperm from his rectum over the previous two years.

He also said he'd been experiencing a problem known as pneumaturia, in which people pass gas in their urine, and fecaluria, in which people pass bowel matter through their urine.

Doctors found that the man's vital signs were normal, and they decided to carry out further tests to see what was going on. A CT scan of the pelvis revealed evidence of a "gas-filled structure" in the man's prostate that appeared to be connected to the rectum.

This is known as a fistula—an abnormal connection between two body parts.

In an attempt to work out the cause, doctors considered inflammatory bowel disease and tuberculosis. They also asked the patient if he had had any abdominal surgeries or experienced penetration or trauma to the rectum that might have contributed to his symptoms. He said he had not.

After investigating more, the doctors found that the man had been in a three-week coma around two years prior due to drug intoxication.

During this time the man had had a Foley, or urinary, catheter inserted—a tube that drains the bladder of urine—and the doctors said this appeared to have caused "significant trauma" which led to the man's current condition.

Doctors successfully performed surgery to block the connection between the man's prostate and rectum, and he recovered.

The doctors at the University of Texas described the case as "unique" and "curious" and published their peer-reviewed report in the Cureus medical journal in August this year.

They concluded that while Foley catheters are important in healthcare, "it is essential to stay wary of its complications."

They added: "This case not only highlights a rare complication of catheter use but also emphasizes the importance of provider mindfulness when utilizing seemingly benign therapies such as Foley catheters."

Connections between the rectum and the urine tube are not unheard of, though they are uncommon, occurring in around 0.5 people per 100,000 per year, according to the study. Most cases in adults are acquired in some way, such as through surgery or a medical condition.

The Texas doctors noted that the passage of sperm through the rectum is so rare that there are few established cases. Previous occurrences involved connections between the rectum and the ejaculatory duct due to surgery for conditions like inflammatory bowel disease or malignancy.