Yang Zhenyu, Xin Peiyuan, Zhou Shuai, Zhou Chuxin, He Xianli, Bao Guoqiang
Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China.
Ann Transl Med. 2022 Feb;10(4):164. doi: 10.21037/atm-22-103.
In recent years, rectal foreign bodies have become a common proctological emergency in the male population, especially older Chinese men, often requiring surgical intervention due to associated complications. This review aimed to describe the epidemiology and clinical characteristics of rectal foreign bodies in older men and examine the possible challenges presented by the condition to clinicians and society.
A comprehensive search was conducted in English-language databases and Chinese databases from January 2000 to December 2020. Studies concerning rectal foreign bodies were considered for this review if they reported the reason for a foreign body being in the rectum and related treatment measures. Contemporaneous rectal foreign bodies case data from General Surgery Department of Tangdu Hospital were also analyzed. According to differences in ethnicity, the older male patients were divided into a Chinese group and a non-Chinese group, and the parameters of the two groups were analyzed using statistical methods.
A total of 159 studies were retrieved in an initial database search using "rectal foreign body" as the search term. These included 86 Chinese studies and 73 English-language studies. Collectively, these studies included 582 older male patients, 276 of whom were Chinese, and 307 who were non-Chinese. According to their source, the rectal foreign bodies were classified into 3 categories. The most common reason for a foreign body in the rectum was insertion for erotic purposes, with everyday articles accounting for most foreign body types. Sexual articles were mainly found to have been used in the pursuit of pleasure. There were no significant differences in foreign body sources, sizes, types, treatment selections, and outcomes between the two groups.
Emergency hospital visits by older men with rectal foreign bodies due to erotic and sexual needs and practices are increasing. Although the sources, sizes, and types of foreign bodies were different, and patients recovered well after active and appropriate clinical treatment, the sexual needs of older men are a social issue that requires attention. Acknowledging and dealing with sexual issues is a multidimensional task that requires a collaborative effort to ensure a more humanistic approach to older patients.
近年来，直肠异物已成为男性人群中常见的直肠科急症，尤其是中国老年男性，由于相关并发症，常常需要手术干预。本综述旨在描述老年男性直肠异物的流行病学和临床特征，并探讨该病症给临床医生和社会带来的可能挑战。
于2000年1月至2020年12月在英文数据库和中文数据库中进行全面检索。如果研究报告了直肠内异物的原因及相关治疗措施，则纳入本综述。同时，对唐都医院普通外科同期的直肠异物病例数据进行分析。根据种族差异，将老年男性患者分为中国组和非中国组，并采用统计学方法分析两组参数。
在初步数据库检索中，以“直肠异物”为检索词共检索到159项研究。其中包括86项中文研究和73项英文研究。这些研究共纳入582例老年男性患者，其中276例为中国人，307例为非中国人。根据直肠异物的来源，将其分为3类。直肠内异物最常见的原因是出于性目的插入，日常用品占大多数异物类型。性用品主要用于追求快感。两组在异物来源、大小、类型、治疗选择和结局方面无显著差异。
因性需求和行为导致直肠异物的老年男性急诊就诊人数在增加。尽管异物的来源、大小和类型不同，且患者在积极适当的临床治疗后恢复良好，但老年男性的性需求是一个需要关注的社会问题。认识和处理性问题是一项多维度任务，需要共同努力以确保对老年患者采取更具人文关怀的方法。
