In most cases, it is only necessary to wait for the packets to pass normally, but if a packet ruptures or if there is intestinal obstruction, then it may be necessary to operate and surgically remove the packets. Oil-based laxatives should never be used, as they can weaken the latex of condoms and cause packets to rupture. Emetics like syrup of ipecac, enemas, and endoscopic retrieval all carry a risk of packet rupture and should not be used. Repeat imaging is only necessary if the mule does not know the packet count.