{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:38:15Z","timestamp":1791221895470,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T00:00:00Z","timestamp":1690243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Introduction:<\/jats:title><jats:p> Foreign body insertion associated with sexual gratification is known as polyembolokoilomania. Following removal of the foreign body, long-term complications are infrequently seen. Whilst conservative and endoscopic approaches usually suffice, in extreme cases open surgical approaches are required. We describe an unusual case of polyembolokoilomania in a 25-year-old male involving a single \u2018AAA\u2019 battery who developed a urethrocutaneous fistula requiring delayed reconstructive surgery. <\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation:<\/jats:title><jats:p> Following an initial successful open extraction of an \u2018AAA\u2019 battery from the mid penile urethra the patient developed a delayed urethrocutaenous fistula of the glans. This was managed using a single stage closure with a preputial graft on its vascular pedicle thereby preserving the foreskin and avoiding a buccal graft. No intra-operative or post-operative complications occurred with a catheter left in situ for 2\u2009weeks. Formal histology confirmed a foreign body type reaction. Following outpatient review successful cosmetic, functional, and sexual outcomes were recorded with questionnaires and medical photography. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> Preputial advancement flap with foreskin preservation for distal urethrocutaenous fistula is a successful method of treating delayed urethrocutaenous fistula of the distal urethra in cases of polyembolokoilomania. <\/jats:p><\/jats:sec>","DOI":"10.1177\/03915603231189026","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T06:49:19Z","timestamp":1690354159000},"page":"226-231","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Preputial advancement flap for delayed urethrocutaneous fistula of the glans following urethral insertion of an \u2018AAA\u2019 battery"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1655-0127","authenticated-orcid":false,"given":"Andrew A","family":"Atayi","sequence":"first","affiliation":[{"name":"Department of Reconstructive Urology, Whiston Hospital, St Helens & Knowsley Hospital NHS Trust, Merseyside, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad M","family":"Omar","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Urology, Whiston Hospital, St Helens & Knowsley Hospital NHS Trust, Merseyside, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Michael S","family":"Floyd","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Urology, Whiston Hospital, St Helens & Knowsley Hospital NHS Trust, Merseyside, 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