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A Brazilian man who had a dumbbell shoved into his rectum had to be ripped out by surgeons.
The unidentified 54-year-old waited two days before seeking medical attention after failing to pull out the 2kg metal weight himself.
He was admitted to a hospital in Manaus complaining of abdominal pain, nausea and inability to empty his bowels.
After an examination of his rectal region revealed no signs of what might be causing his symptoms, doctors ordered an X-ray of his abdomen.
Medics - who suspected the unusual case was "sexual in nature" - said the man was "uncooperative" during the physical examination.
The x-ray showed a dumbbell almost eight inches long stuck where the colon meets the rectum.
Medics sedated the man with surgical forceps for their attempted extraction procedure, but were unable to remove the dumbbell.
With no other option, the team opted for “manual extraction,” in which the surgeon pushed into her “forearm.”
A 54-year-old Brazilian man had a 20cm dumbbell inserted into his rectum after inserting it for sexual pleasure
Attempts by surgeons to remove the object using medical instruments failed, forcing them to take a hands-on approach
The 20cm dumbbell after extraction, pictured next to a 24cm surgical instrument for comparison
Write in International Journal of Surgery Case Reports They claimed it was fraught with "difficulties" but ended in success when the man was discharged after three days in hospital.
Doctors said the majority of patients admitted with retained rectal objects are white men between the ages of 20 and 40.
Sexual satisfaction is the most commonly cited reason for items getting stuck.
This partly has to do with the number of nerves in the anus, which make it very sensitive.
In men, it can also simulate the prostate – an erogenous region of the reproductive system.
In women, it can also indirectly stimulate pleasurable centers in the vagina.
Medics also said many patients come to the emergency room only after repeated failed attempts to extract the objects themselves.
In this case, it is expected that the man will not suffer any long-term complications.
However, the report authors said other cases can lead to internal injuries and fecal incontinence.
Dr. Ana Elisa de Landa Moraes Teixeira Grossi and colleagues did not provide information about when the incident occurred.
NHS doctors spend around £300,000 a year extracting items from British rectums, experts believe.
The Royal College of Surgeons report found that NHS hospitals had removed 3,500 objects between 2010 and 2019.
MailOnline has previously reported on people using toothbrushes, aerosol cans, toy figurines and eggs in their pursuit of sexual pleasure.
A British study found that the frequency of objects needing to be removed from the rectum is increasing, with cases particularly increasing in men
People in their 20s were most likely to have an object stuck in their rectum, followed by people in their early 50s