Non-traumatic Anorectal Foreign Bodies: A 10-Year Tertiary Center Experience

TL;DR

This study examines 10 years of anorectal foreign body cases at a hospital, finding that many require surgery and that outcomes are generally good with proper care.

Contribution

The study provides a detailed analysis of management strategies and outcomes for anorectal foreign bodies over a decade at a tertiary center.

Findings

Males were more commonly affected, with significant age differences compared to females.

Surgical intervention was required in nearly half of the cases, with rare postoperative complications.

Food products were the most common foreign bodies, while sex toys were equally reported among genders.

Abstract

Background

Anorectal foreign bodies (AFBs) represent a challenging clinical problem with rising incidence, diverse presentations, and potential for serious complications. This study reviews a decade of experience at a tertiary referral center, analyzing demographics, management strategies, and outcomes.

Methods

A retrospective review was conducted of all patients presenting with AFBs between January 2014 and April 2024 at Rambam Health Care Campus. Data collected included demographics, type of object, diagnostic approach, management strategy, and complications. Statistical analyses used ANOVA, Chi-squared, and Fisher's exact tests, with p<0.05 considered significant.

Results

Thirty-nine patients were identified, 74.4% of whom were male. Males presented at an older mean age than females (49.4 ± 19.3 vs. 35.4 ± 12.5 years, p=0.015). Food products were the most common foreign body overall, and sex toys were reported equally among both genders (p=0.087). Almost half of the patients required surgical intervention (48.7%), while 28.2% were managed by manual extraction and 7.7% experienced spontaneous expulsion. Unspecified objects were significantly more likely to be managed non-operatively (p=0.016). Most cases were diagnosed clinically (71.8%), and 19 patients required surgery, including five who underwent laparotomy for proximal impaction or perforation. Postoperative complications were rare (2.6%), with no mortality observed.

Conclusion

Anorectal foreign bodies remain an uncommon but clinically important condition, predominantly affecting males, with significant gender differences in age but not in object type. While many cases can be managed conservatively, nearly half require surgical intervention, and a minority necessitate laparotomy. Complications were infrequent, suggesting that timely, structured management may contribute to favorable outcomes in experienced centers. Early recognition, standardized treatment algorithms, and stigma reduction may further improve outcomes and patient safety.