Bleeding as the result of a leech in the male urethra is very rare. We describe a 13-year-old boy who had a leech in his urethra. In the emergency department he persistently squeezed his penis in an attempt to prevent the leech from going deeper into his urethra. Manual removal by forcep failed and cystoscopic removal was recommended. Penile block with lidocaine 1% relieved the pain and enabled him to squeeze his penis harder until the leech was pushed out making forcep removal easier. Post-removal he had hematuria and penile pain for 2 days. A description of his presentation and management, along with a review of the literature is presented.
A case of urogenital myiasis caused by Chrysomya bezziana (Diptera: Calliphoridae) was diagnosed in a 76-year old patient who had carcinoma of the rectum. A total of 35 larvae were obtained from ulcers near the external genitalia and urethra opening. Larvae pupated within 1 to 2 days and 6 days later emerged as adult males. These were identified as Chrysomya bezziana. Female flies possibly attracted by the fetid odour, laid eggs in the existing lesions in the urogenital area, the larvae invading and feeding on living tissue. Lack of personal hygiene was the contributing factor for the cause of urogenital myiasis in this patient.