Recent ER Consult

ID: 56 yo M from home, previously well
RFR: pain in penis

HPI: Pt was "playing around" last night after dinner and placed a 2cm oblong polished stone into his penile meatus. When he realized he was unable to remove it, he panicked and tried to pull it out, forcing it further up towards his bladder. Two hours later, after feeding his chickens and helping his neighbour move a table, he presents to the ED. During examination, he repeatedly stresses that he is "not gay."

Pelvic XR: fails to demonstrate any radio-luscent mass in his urinary tract. Bladder is clear.

Assessment: paraphilia versus delusional disorder

Plan: To home. Return to clinic if any difficulty voiding. Followup with family physician.