Objective: Retained rectal foreign bodies (RFBs) present significant management challenges because of the lack of standardized clinical algorithms. We aimed to evaluate our institutional experience in managing consecutive cases of RFBs over a 44-month period (January 2018 to August 2021).
Materials and Methods: The medical records of 16 consecutive adult patients diagnosed with RFBs between January 2018 and August 2021 were retrospectively reviewed. Demographic characteristics, clinical and diagnostic findings, object characteristics, extraction methods, length of hospital stay, and complications were evaluated. Complications were graded according to the Clavien-Dindo classification.
Results: The mean patient age was 56 years (median, 61.5 years; range, 18–95 years), and 15 patients (94%) were male. Sexual gratification was the primary etiology in 13 cases (81.3%). Transanal extraction under anesthesia was attempted in 13 patients (81.3%) and was successful in 12 (92.3%); 11 of the 16 patients (68.8%) were definitively managed using the transanal approach alone. Colonoscopic retrieval was successful in 1 patient (6.3%). Laparotomy was required in 4 patients (25.0%): 2 underwent surgery for perforation with peritonitis at admission, 1 required surgery after failed transanal retrieval of a proximally migrated, impacted object, and 1 underwent surgery for delayed perforation detected after technically successful extraction. Complications occurred in 3 patients (18.8%). The median hospital stay was 2 days (range, 1–15 days), and no deaths occurred.
Conclusion: Most RFBs can be safely removed via the transanal approach under anesthesia in the operating room, ensuring patient privacy and optimal muscle relaxation. Emergency laparotomy remains mandatory in cases of perforation or failed extraction, and structured post-extraction observation is essential for the early detection of delayed perforation.