Tell me if you’ve heard this one… A 33-year-old man cums out of his ass for two years before he seeks medical attention. You may think this sounds a little like the story of the businessman who wakes up in a bathtub full of ice with a kidney missing, but unlike that particular urban legend, the story about the poor guy who had the unfortunate case of rectal ejaculation is true.

Researchers from the University of Texas Medical Branch at Galveston detailed the case of the man ejaculating from the anus in an aptly titled study called “A Curious Case of Rectal Ejaculation” that was published in the Cureus Journal of Medical Science. What they found was not only a case of semen passage through rectum, but also a case of passing feces with urine and urine with feces via rectourethral fistula, an uncommon condition where there is a fistula (an abnormal connection between body parts) from the rectum to the lower urinary tract.

RUFs have an incidence of 0.5 cases per 100,000 people each year. In adults, these abnormal connections are usually caused by some sort of trauma, surgery, radiation, or inflammatory condition like Crohn’s disease. They can also be caused by prostate fistula or urological complications following therapy for male reproductive health issues. Symptoms of RUF can include semen leakage from anus , feces in the urine, urine in the feces, semen discharge issues , and abnormal ejaculation .

For this particular 33-year-old, the problem likely started when he was put into a medically induced coma after a drug overdose. It’s hypothesized that while he was in the coma, a Foley catheter complication occurred due to improper insertion. In case you didn’t know, a catheter is a tube that’s inserted into a patient’s urethra to drain the bladder of urine. Catheters are extremely common for hospitalized patients, but as this case shows, anything that’s inserted into the body must be done so with great care to avoid serious male sexual health concerns .

The patient finally went to the doctor because he was having intense testicular pain over the course of five days. It was at that point that he told the doctors that he’d been passing semen in stool and urine from his anus for two years. He also said that he had experienced feces in his urine as well. What the doctors found was a fistula between the patient’s rectal-prostate connection , which was responsible for his bodily fluids exiting in all the wrong ways.

As horrifying as this story is, it did end up having a happy ending and a moral to boot. Doctors were able to patch the fistula through surgery, and the patient was able to make a full physical recovery with the only side effect being reduced semen volume over several months. If he had not sought treatment, it’s likely that this condition would have become life-threatening. The authors concluded the study by saying, “This case not only highlights a rare complication of catheter use but also emphasizes the importance of provider mindfulness when utilizing seemingly benign therapies such as Foley catheters.”

I would like to conclude this article by emphasizing the importance of getting your ass to the doctor when you have anything going wrong with your junk. Do not wait two years like this patient did. I get it. Conditions like ejaculatory duct issues , masturbation and erectile dysfunction , low semen volume, poor sperm quality, bad-tasting cum, or infertility can make a patient embarrassed and reluctant to seek care. As a male reproductive health expert, I assure you, no matter what your problem is—even if it’s anal ejaculation causes —we will not laugh and we will not judge. We are here to help.