# Déjà Vu in the Operating Room: Recurrent Extraction of an Anal Sexual Foreign Body

## TL;DR

A man repeatedly inserted and removed large foreign objects rectally for sexual stimulation, highlighting the need for multidisciplinary care.

## Contribution

This case report highlights polyembolokoilamania and emphasizes the need for psychiatric evaluation alongside surgical management.

## Key findings

- A 39-year-old man presented four times with progressively larger rectal foreign bodies for sexual stimulation.
- All objects were successfully removed without complications using radiographic imaging and sedation.
- The case underscores the importance of addressing psychosocial factors to prevent recurrence.

## Abstract

Rectal foreign body insertion is an uncommon presentation that may lead to serious complications if not promptly recognised and properly managed. While many cases are related to sexual experimentation, repeated insertions can reflect underlying behavioural or psychiatric conditions. The behaviour, known as polyembolokoilamania, remains insufficiently described in current medical literature, particularly when it involves recurrent episodes in the same individual. We report a 39-year-old male patient with no significant comorbidities who presented on four separate occasions over a two-year period following the insertion of rectal foreign bodies for sexual stimulation. The objects progressively increased in size, from a 5 cm spherical item to a 10 cm soft plastic ball. All were successfully removed manually under sedation, without perforation, bleeding, or other complications. Radiographic imaging was used in each episode to confirm the position and dimensions of the objects prior to extraction. This case illustrates the diagnostic and technical challenges associated with recurrent rectal foreign body insertion, as well as the need to address underlying psychosocial and psychiatric factors that contribute to recurrence. Successful management relies not only on careful surgical extraction but also on comprehensive evaluation and follow-up. A coordinated, multidisciplinary approach-combining surgical expertise with psychological and psychiatric support-is essential to prevent further episodes and to improve long-term outcomes in patients presenting with polyembolokoilamania.