Abstract
<title>Abstract</title> <p>Background Lower urinary tract foreign bodies are uncommon in urological presentations that often pose diagnostic challenges, particularly in patients with communication barriers. Rubber tubes represent a distinct subset of self-inserted objects, frequently associated with autoerotic stimulation or psychiatric conditions. Case presentation: We report the case of a 54-year-old deaf-mute male who presented with abnormal behavior (as described by the family, the patient constantly touching the scrotum and urethra, and urinating through a bag covering the penis). Imaging studies revealed a cylindrical object within the urinary bladder and urethra. Due to the patient's inability to provide a clear history and the atypical presentation, the diagnosis mainly relied on imaging examinations, and the insertion motivation was mainly based on speculation. The foreign body was successfully removed through the eteroscope, with an uneventful postoperative recovery. Conclusion Clinicians and family should maintain a high index of suspicion for intravesical foreign bodies in deaf-mute patients presenting with unexplained lower urinary tract symptoms, recurrent infections, or obstructive uropathy. A systematic approach to diagnosis and individualized surgical planning are essential for optimal outcomes.</p>