膀胱異物(雷射筆及塑膠管)病例報告

邱泰樺、溫聖辰

高雄醫學大學附設中和紀念醫院 泌尿部

Laser pointer and plastic tube as foreign bodies in urinary bladder: a case report

Tai-Hua Chiu, Sheng-Chen Wen

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

Case presentation:  
Here we presented a case of a 45-year-old male with a medical history of bladder foreign bodies insertion presented to emergency department with a symptom of dysuria. The patient claimed that he inserted two batteries cells into his bladder. Physical examination and blood test revealed no specific finding. Urine analysis disclosed hematuria and pyuria. Transabdominal ultrasound showed a rectangular-shaped mass with hyperechogenicity. KUB X-ray showed a foreign body measuring approximately 1.8cm x 8cm in the bladder (Figure 1). The patient underwent cystoscopy which revealed a laser pointer is enclosed within a yellow plastic tube. The foreign bodies cannot be removed by standard stent removal forceps due to their size and texture. We applied a nephroscope without outer sheath into bladder and used a laparoscopic bowel grasper forceps to remove the laser pointer first. The plastic tube was then also removed by the same forceps by grasping the smooth end of the tube (Figure 2). The patient developed a fever due to a urinary tract infection after the procedure. After three days of intravenous third-generation cephalosporins administration, the patient recovered and was discharged.

Discussion:

Urologists occasionally encounter patients with bladder foreign bodies in the emergency department. Cystoscopic removal is the standard treatment for bladder foreign bodies, but the difficulty of removal varies depending on the type and material of the foreign body. Usage of nephroscope with aid of proper large forceps is a safe method to remove medium-sized rectangular-shaped bladder foreign bodies.