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Intraurethral Cocaine Administration

John C. Mahler, MD; Samuel Perry, MD; Bruce Sutton, MD
JAMA. 1988;259(21):3126. doi:10.1001/jama.1988.03720210016009.
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To the Editor.  —More than 100 years ago JAMA reported the intraurethral administration of cocaine as an anesthetic for "the introduction of a bougie."1 To warn clinicians that this route has now become a method of self-administration of cocaine,2 we report the following case and its extravagant complications.

Report of a Case.  —A 34-year-old man was admitted to a local hospital with a three-day history of priapism and paraphimosis. During the previous weeks he had occasionally administered cocaine intraurethrally prior to intercourse to enhance sexual performance. Except for priapism and paraphimosis, findings from initial evaluation were unremarkable. There was no evidence of intranasal or intravenous substance use or of any of the usual causes of priapism.3-5 Aspiration of the corpus cavernosa was attempted without benefit and a Foley catheter was inserted to relieve his difficulty in voiding.On the third hospital day the priapism and paraphimosis spontaneously resolved,


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