Migration of a urethral foreign body into the scrotum in an adolescent: a case report

Urethral foreign body insertion is an underreported issue in adolescents. Migration to the scrotum is exceptionally rare, with < 20 cases reported. We highlight diagnostic and management challenges. A 14-year-old boy presented with 11 days of progressive scrotal pain, swelling, and fever (38.5 °C). Computed tomography (CT) revealed an 8-cm hyperdense foreign body extending from the urethra into the scrotum. Surgical exploration identified an embedded cotton swab with purulent exudate. Combined scrotal exploration and cystoscopy achieved complete retrieval. After a 3-week catheterization, recovery was uneventful. One-year follow-up showed spermatic cord fibrosis but preserved testicular function. Cross-sectional imaging is critical for diagnosis. Combined surgical approaches optimize outcomes for large migrated foreign bodies. Adolescents require psychological intervention to prevent recurrence.