While the idea of an earthworm inside a penis sounds like fiction, it is a recognized, albeit rare, medical event. These occurrences are not parasitic infections but are documented as instances of foreign body insertion into the urethra, the tube that carries urine from the bladder. This article explores the clinical reality of this phenomenon, examining documented cases, the biological context, resulting medical complications, and the procedures physicians use to resolve it.
Documented Medical Cases
Medical literature catalogues a wide variety of foreign objects retrieved from the human urinary tract, and among these, worms are noted. These instances are the result of self-insertion. While specific, peer-reviewed case studies on earthworms are scarce, a highly illustrative case involved an object designed to mimic one: an artificial fishing worm. This case provides significant insight into how the medical community approaches such a scenario.
In one published report, a 63-year-old male presented to his urologist with a year-long history of recurrent urinary tract infections and pelvic pain. His symptoms would temporarily improve with antibiotics but always returned, prompting further investigation. An initial ultrasound revealed calcifications within the bladder, and a subsequent cystoscopy revealed a large, hardened mass. The object was so large that it required open surgery on the bladder, a procedure called a cystolithotomy, for removal.
The object at the core of this mass was identified as an artificial fishing lure, which the patient later admitted to inserting three years prior. This case is significant because it shows how a foreign object becomes a nucleus for a large bladder stone, or calculus, causing the patient’s long-term symptoms.
Pathways of Entry and Biological Context
The entry of an earthworm into the penis is a mechanical insertion of a foreign body into the urethral opening, often associated with sexual curiosity. Earthworms do not seek out human hosts and lack the mechanisms to invade the body. The object enters the urethra and can travel into the bladder.
The human urinary tract is an inhospitable environment for an earthworm. Urine’s chemical composition and pH are toxic to it, and the urinary tract lacks the soil and organic matter an earthworm needs for food and oxygen. An earthworm would quickly perish, and its body would be treated by the immune system as a foreign object.
This is unlike a true urinary parasite like the giant kidney worm (Dioctophyme renale), which can survive and grow within the urinary system.
Medical Symptoms and Complications
Introducing an object like an earthworm into the urethra triggers immediate symptoms. The person would likely experience severe pain during urination (dysuria), a burning sensation, and a feeling of obstruction. The worm’s physical presence can block urine flow, leading to urinary retention, the inability to empty the bladder.
Trauma to the urethral lining can also cause bleeding, resulting in blood in the urine (hematuria). These symptoms often compel an individual to seek medical attention. The body’s immune system responds to the foreign material, which can lead to inflammation of the urethra (urethritis) and bladder (cystitis).
If the object is not removed, the most common long-term complication is bladder stone formation. The deceased worm acts as a nidus, or central point, for minerals in the urine to crystallize upon. This creates a calculus that can grow large, leading to chronic infections, persistent pain, and potential kidney damage.
Diagnosis and Removal Procedures
Diagnosis begins with the patient’s history and a physical examination, followed by imaging studies. An ultrasound or CT scan can visualize an object or a resulting bladder stone within the urinary tract. The primary diagnostic tool is a cystoscopy, which involves inserting a thin tube with a camera through the urethra. This allows a urologist to directly observe, identify, and determine the size and location of the foreign object.
Removal methods depend on the object’s size and location. Small objects can often be removed during the cystoscopy using small forceps or a basket-like instrument passed through the scope. For larger objects or those encased in a significant bladder stone, a more invasive surgical procedure like an open cystolithotomy is necessary. This involves cutting into the bladder to remove the mass.