尿道球部的棉花棒 : 病例報告

陳建凱、王百孚、石宏仁

彰化基督教醫院 外科部 泌尿科

Cotton swab in the bulbar urethra : a case report

Jian-Kai Chen、Pai-Fu Wang、Hung-Jen Shih

Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

Introduction:

    Intraurethral or intravesical foreign bodies typically arise from iatrogenic injuries, self-insertion, sexual abuse, assault, or migration from nearby sites, although the latter occurrence is uncommon. The frequency of admissions associated with this phenomenon seems to be rising, potentially attributable in part to a growing use of urethral sounding for sexual pleasure. We report a case who inserted the cotton swab into the bulbar urethra and the foreign body was removed successfully.

Case report:

    The patient is an 80-year-old married Taiwanese man without any past history and known adverse drug reaction. He visited our emergency department due to insertion of cotton swab by himself. He complained about voiding difficulty and foreign body could not be removed. Physical examination revealed no foreign body sensation during palpation of penis and perineum and silk thread emerges from the meatus. Non-enhanced computed tomography of the urinary bladder and abdomen revealed suspected radiolucent foreign body in the prostatic urethra. Under cystoscopy, cotton swab tied with thread stucked in bulbar urethra and urethral false lumen. We used teeth forceps to adjust the direction of the foreign object parallel to the urethra, and move the cotton swab along the true lumen to keep it away from the false lumen. Then, clamped the cotton swab tip and removed it from urethra slowly.

Conclusion:

    Urethral foreign bodies are uncommon, and their extraction might be difficult. Treatment should focus on the extraction of the foreign item, prevention of complications, and preservation of erectile function in male patients. The technique for foreign body removal should be determined by the object's size, characteristics, and motility. Endoscopic procedures should be prioritized if the object can be extracted without causing urethral injury.