Urethral Polyembolokoilamania: An Unusual Manifestation of Behavioral and Psychological Symptoms of Dementia (BPSD

Behavioral and psychological symptoms of dementia (BPSD) have varied presentations and frequently occur throughout thetrajectory of dementia. Hypersexuality and general disinhibition of societal and cultural norms are commonly documentedin all types of dementia. However, sparse literature exists on polyembolokoilamania (insertion of foreign objects in bodilyorifices) without a sexual component as a dementia-related symptom. We review an unusual case of a 94-year-old man whopresented with urethral polyembolokoilamania without hypersexuality or other behavioral disinhibition. We highlight clinicalconsiderations of managing urethral polyembolokoilamania in an elderly patient without a previous neurocognitive disorderdiagnosis. A multidisciplinary team approach with input from Internal Medicine, Urology, Psychiatry, and Neurology lead to acomprehensive assessment of a patient that could have been managed solely as a surgical case. This spearheaded a formal diagnosisof neurocognitive disorder—guiding successful management, follow-up, caregiver education, and reduction of further harm.