This is the moment doctors discovered an elderly man’s penis became infested with maggots.
The 76-year-old sought medical attention after four days of bloody urine and discharge coming from his penis.
Two years prior he had suffered an enlarged prostate – the gland between a man’s bladder and rectum – which blocked his urethra, so he had to have a catheter placed in his penis to help him urinate.
The man, from Nepal, was also partially paralyzed on his left side, leaving him unable to clean himself and dependent on his wife for basic hygiene.
Doctors performed a cytoscopy, which involves weaving a thin tube with a camera through the urethra and bladder, and found ‘multiple maggots’ squirming around the man’s penis and bladder.
The team suggested poor hygiene and using a catheter long term could be to blame, as bacteria can easily enter the urinary tract and cause infections.
Doctors believe there are only a handful of reported cases of maggots infesting the penis, called penile myiasis, and even fewer of them travelling to the bladder.
The case was detailed in a medical journal last month.
The above images from inside the man’s bladder and urethra show one of ‘multiple’ maggots crawling through the organ
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Doctors treating the man wrote: ‘The discovery of maggots in both the penis and urinary bladder is an uncommon and alarming occurrence.’
They also noted maggot infestation in the bladder is ‘very rare, and it indicates the severe and invasive nature of the disease.’
Penile myiasis is an extremely rare infection caused by maggots, or fly larvae, infesting the penis.
It’s thought that the strong odor and tissue decay from poor hygiene attracts flies to swarm and lay their eggs, which turn into maggots.
The maggots then burrow into the skin and feed on tissues, causing inflammation.
In the unnamed man’s case, doctors wrote: ‘Another potential route of infestation is through contaminated medical instruments, such as catheters or syringes used for douching.
‘These instruments, if exposed to urine or pus, can attract female flies looking to lay their eggs.’
The infestation caused the tissues around the man’s penis to become severely swollen.
The maggots also moved through his urethra to his bladder, causing his bladder walls to thicken.
Only a handful of cases of penile myiasis have been reported globally.
In one case report, a 21-year-old man in Brazil complained of a small itchy and painful lesion on the tip of his penis.
He told doctors that shortly before the lesion formed, he had noticed more flies in his house than usual.
Because he would occasionally sleep naked and only took quick showers before work, doctors believed the flies from his apartment had laid eggs around the man’s penis.
Also in Brazil, a 62-year-old man was diagnosed with penile myiasis due to several years of taking care of farm animals, which attract flies, while wearing shorts but no underwear.
And in 2023, a toddler in Nigeria was brought to the hospital with severe penile swelling and pain.
On his third day in the hospital, doctors noticed a maggot coming out of a lesion on the child’s penis.
The man in Nepal was treated with bladder irrigation, which involves flushing the bladder with sterile solutions to get rid of bacteria or other debris.
Doctors also gave him a single tablet of ivermectin, which is normally given to animals to kill maggots.
The man was hospitalized for 11 days and returned a week later to be circumsized, as the inner foreskin is most vulnerable to infections.
