The patient was 59 years old and was admitted with a gunshot wound with an entry wound in the buttock, about 4 millimetres in diameter and no exit wound. He also had another gunshot wound to the right thigh with an entry wound to the back and exit wound to the front, without affecting important structures. The patient is conscious, oriented and with a slight abdominal defence. The plain abdominal X-ray shows a bullet located at the level of the symphysis pubis, as well as a fracture of the right descending branch of the pubis. The patient arrived in retention, and catheterisation was impossible, so a suprapubic catheter was inserted. A laparotomy was then performed, but no other lesions were found, and a left colostomy was performed. The following day, a urethrography was performed, and it was found that contrast was passing from the urethra to the rectum, causing high fever with chills that lasted for a few days. Subsequently, five days after the first operation, the patient is taken to the operating theatre and a colonoscopy is performed, revealing rectal perforation. An endoscopic urethrotome was then introduced into the prostatic urethra and the apparently large orifice that joins the urethra to the rectum was visualised. Despite this, the path to the bladder is found and an eighteenth catheter is left in place.

Then, in the same surgical act, a laparotomy is performed up to the symphysis pubis, the abdomen is checked again and no lesions are found. The Retzius space is then dissected and the anterior aspect of the prostate, which is hyperplastic, is palpated by radiological control until the projectile is touched. The bullet is then grasped and removed with a ring forceps under radiological control. The postoperative period is uneventful and the patient is discharged a few days later with the probe in place.

After three months the patient was asymptomatic, a new colonoscopy was performed, the rectal orifice was found to have disappeared and the colostomy was closed without incident. However, the tube is left in place for a further three months, i.e. a total of six months. At the end of this time, a urethrogram is performed again, the gap is found to have closed and the catheter is removed. Six months later, the patient returns for a follow-up, is asymptomatic and with normal sexual function; this time only an ultrasound is performed, which is normal, and he is definitively discharged.

