In emergency rooms, doctors face the ominous specter of life, death and everything in between. In those bustling but sanitized and always white-lit rooms, they save lives, avert tragedies, and sometimes, witness our deepest awkward moments.
Over the years, foreign object removals, or extractions of objects from bodily orifices, have become increasingly common in emergency wards around the world. In the majority of reported cases involving adults, objects tend to have been self-inserted through the anus, vagina and urethra for sexual pleasure and needed a medical intervention to be retrieved.
In Pakistan and in many parts of Asia, the phenomenon is relatively less reported compared to other countries, especially in Eastern Europe, which has the highest rate of cases involving rectal foreign bodies. In Pakistani society, sex and masturbation are considered taboo and even inflammatory subjects under strict religious and cultural codes. Regardless, local doctors continue to fish out a kaleidoscopic range of common household objects from people’s sexual orifices.
“I’ve seen people who've had a variety of objects, which vary from tiny things to large, impossible things,” Karachi-based general surgeon Dr. Rizwan Azami told VICE World News. Azami has surgically removed lodged objects from 20 patients in the last 40 years.
Documented cases include the use of long cylindrical objects for anal stimulation such as flashlights, steel or iron rods, knitting needles, dildos, vibrators, and most commonly, beverage bottles. Objects of the vegetable variety include carrots, radishes and cucumbers.
Other reported objects include pieces of wood, stones, ladles, metal cups, toothbrushes, bathroom brush handles, shards of glass and, in one case, even a knife. In cases involving items used for sexual arousal through the urethra, pens, metal wires, headless nails, thermometers and bobby pins have been reported. A vast majority of the recorded cases involved males between the ages of 15 and 80.
A recent study investigated cases of rectal foreign bodies including those that had been used for masturbation. Objects found included a spray can, a candle, a plastic toothbrush case, beverage bottles, and batteries. Another study published in 2019 recorded rectal foreign body removals in Pakistan’s southern city of Sukkur.
“The first thing I encountered was a green stick – a guy had pushed it so far down that it perforated his gut loop and went into his abdomen. I came across other cases that involved a lightbulb, an iron rod, a bottle, and a hairbrush," Lahore-based emergency room doctor Feroz Khawaja told VICE World News. Khawaja has encountered around 10 cases of foreign object insertions in the span of one year.
“There was this one really old man who came up with a urinary obstruction – he actually had a cockring made of thread stuck on his penis.”
Sexual experimentation and, at times, masochistic desires to enhance pleasure through pain were behind people trying to masturbate with household objects, the doctors found.
“The reason behind this is because human beings are very curious creatures. They want to increase their pleasure by trying to use different kinds of objects,” Lahore-based sex therapist Tahira Rubab told VICE World News.
In Pakistan, public perceptions and attitudes surrounding sexuality and masturbation are largely dictated through the lens of religious tradition and politics. Dialogues and expressions involving sex are often met with public outcry and criticism.
According to a survey that investigated the sexual attitudes of young men in the southern province of Sindh, 94 percent of respondents admitted to masturbating but 74 percent of them associated it with feelings of guilt. Societal moral policing and the lack of adequate sex education have increasingly led people to repress their sexual desires and anxieties.
“I have seen people crying in front of me when they disclose their sexual fantasies because they have felt that they can't find anybody to talk to about these things, which makes them even more frustrated. There is no place where they can openly talk with confidence and get even the most basic information about sex and their own bodies,” said Rubab.
In foreign object cases involving sexual pleasure, most patients do not feel comfortable disclosing the causes of their injuries, the doctors said. Social embarrassment leads many to even delay seeking medical help in the first place.
“They are upset about having to explain themselves. it's like presenting yourself instead of getting caught. They don't want to talk about it and they feel ashamed. Explaining it to a stranger is bad enough, but there is a fear deep down inside them that a doctor will go and blurt it out in front of their family or attendants. It's very emotional for them,” said Azami.
“When they do seek help, they don't want to disclose everything. They'll say, ‘We don't know how it happened. I was walking and I fell down from a desk.’ Imagine a three or four-inch object in diameter entering your anus without being inserted. How can that happen?”
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