Frankly, this is a bit gross. I’ll put the post below the fold, and read at your own risk. You’ve been warned.
Removal of a rectal foreign body is simple, really: Locate it, grasp it firmly, break the ‘suction’, and pull. Seems simple, and like most seemingly simple tasks it’s harder to accomplish in real life.
The patient of a colleague had just such a complaint, and I willingly agreed to help remove the object, which we had an x-ray of, a common vibrator. On delegation of tasks my colleague would be in charge of the patients’ sedation, and I was on removal duty.
I had all I needed, a plastic and lit vaginal speculum, ring forceps, some nice plastic tubing (for suction relief), and lube.
The patient was suitably sedated, and it was time to proceed. The speculum was inserted, and no foreign body was visible until the anterior abdomen was compressed, and !viola!, it appeared. I saw a small area of man made black color, and the unmistakable edge of a condom on its edge. I carefully grabbed the rim of the condom (at the near-limit of the reach of the ring forceps, probably 8 inches in) and began to hopefully tug.
Hope may well float but condoms just break, and when they do they recoil in both directions with fervor and throw-off anything attached. In this case I protected the team by taking the hit squarely in the face. (This has become something of a topic of conversation in my ED).
No, I wasn’t wearing protection beyond beyond my usual spectacles. I did try another two times to grasp the end of the vibrator with the ring forceps, but could never get enough of a hold to even attempt to break the suction (due to the tapered design of the end of the vibrator) (which design I learned from reading the Internet).
In retrospect, a tenaculum might have allowed a better grip on the vibrator, but given our thorough attempts the surgeon on call took the patient in and the object out.
I washed my face at the sink for a nice, long time, and have thought about getting a tenaculum prior to the next time. Oh, and one of those face mask-shield things.