Surgeons needed to remove two nails from a schizophrenic man’s scrotum after he followed ‘the command of an imaginary person’.
Sharing gory details of the incident in a medical journal, medics in Tunisia told how the unidentified 23-year-old’s testicles remained intact.
The man, who had not previously been diagnosed with any mental health condition, turned up at hospital complaining of pain in his testicle two days after the incident. Psychiatrists diagnosed him with schizophrenia after concluding that he committed the self-mutilation while suffering from ‘delusions’.
Doctors at La Rabta Hospital in Tunis said they believe the case is the first involving a schizophrenic man inserting an object into his scrotum.
Schizophrenic patients usually insert an object in the mouth or rectum, but insertion of foreign body in scrotum is not reported in our knowledge,’ they added.
The man told medics in the hospital’s urology department that he had been suffering from pain in his scrotum for two days.
After being quizzed by doctors, he admitted to inserting two nails into his scrotum. One measured 6cm.
Upon examination, one of the nails, which was thicker, could be seen piercing the scrotum in two places.
An X-ray of the pelvis revealed a second, smaller nail fragment was lodged below the pubic symphysis, the joint sandwiched between the left and right pelvic bone.
The man attributed his action to ‘the command of an imaginary person’. He was later referred to the psychiatric department who diagnosed him with schizophrenia
The man was given an tetanus jab. It protects against the life-threatening condition, which is caused by bacteria getting into a wound.
Medics removed dead and infected tissue, thoroughly cleaned the wound and removed the nail.
Remarkably, he suffered no lasting damage to his testicles or epididymis — the tube that stores sperm.
He was discharged from hospital the next day and referred to the psychiatric department, where medics confirmed he was suffering from serious mental health issues.
They prescribed him antipsychotics — drugs which reduce and control the symptoms of schizophrenia, including delusions and hallucinations.
Writing in the journal Urology Case Reports, medics said retrieving objects stuck in the scrotum are fortunately rare.
But they said: ‘Presentation is usually delayed due to feelings of shame and embarrassment.
‘When they occur, they can result in serious complications such as testicular tissue loss or urethral strictures.’
They added: ‘In our case the patient was suffering from schizophrenia, and under the command of an imaginary person, he would put objects into his scrotum.’
The self insertion of foreign bodies in the scrotum or in the lower urinary tract can have various causes.
These could include psychological and psychiatric factors such as mental illness, borderline personality disorder, drug abuse and migration from other organs, they said.
The cause of schizophrenia is not understood and it is believed to be a mix of genetics, abnormalities in brain chemistry and/or possible viral infections and immune disorders.
Symptoms of schizophrenia usually begin between ages 16 and 30. They include hallucinations, muddled thoughts and speech and wanting to avoid people.
Figures suggest around one percent of the world population suffers from schizophrenia, including around 685,000 in the UK and two million in the US.
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves.
People with schizophrenia may seem like they have lost touch with reality.
The cause of schizophrenia is not understood and it is believed to be a mix of genetics (hereditary), abnormalities in brain chemistry and/or possible viral infections and immune disorders.
Symptoms of schizophrenia usually begin between ages 16 and 30. In rare cases, children have schizophrenia too.
The symptoms of schizophrenia fall into three categories: positive, negative, and cognitive.
Positive symptoms are disturbances that are ‘added’ to the person’s personality and include:
- Hallucinations
- Delusions
- Thought disorders (unusual or dysfunctional ways of thinking)
Negative symptoms are capabilities that are ‘lost’ from the person’s personality and include:
- ‘Flat affect’ (reduced expression of emotions via facial expression or voice tone)
- Reduced feelings of pleasure in everyday life
- Difficultly beginning and sustaining activities
Cognitive symptoms are changes in their memory or other aspects of thinking and include:
- Trouble focusing or paying attention
- Problems with ‘working memory’
- Poor ability to understand information and use it to make decisions
Figures suggest around one percent of the world population suffers from schizophrenia with around two million in the US.
Source: National Institute of Mental Health
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