<![CDATA[Self-inflicted urethral foreign body insertion is a rare urological emergency frequently associated with psychiatric disorders and may present significant management challenges, particularly when sharp metallic objects are involved. We report the case of a 44-year-old man with schizophrenia who presented with meatal bleeding and penile pain after self-inserting a needle into the urethra. Clinical evaluation, pelvic radiography, and urethroscopy revealed a 10-cm needle lodged transversely in the bulbomembranous urethra with bilateral mucosal penetration. The foreign body was successfully removed through a minimally invasive endoscopic approach under direct visualization, without fragmentation or the need for open surgery. The patient experienced an uneventful postoperative recovery and was referred for psychiatric follow-up. This case demonstrates that careful endoscopic planning and controlled extraction can facilitate the safe management of sharp urethral foreign bodies even in anatomically challenging locations, while multidisciplinary psychiatric care remains essential to prevent recurrence.]]>
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