特殊的下泌尿道異物
林于巧、歐穎謙
國立成功大學附設醫院 泌尿部
Special foureign bodies in lower urinary tract
Yu-Chiao Lin, Ying-Chien Ou, Wen-Horng Yang
Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
Introduction:
Foreign bodies in lower urinary tract were mostly self-inflicted and related to exotic impulses or psychometric problems. Treatments, such as manual retrieval, endoscopic removal or open cystotomy, have been reported before. Here we introduce two cases of self-inflicted foreign body in low urinary tract, ending up using different surgeries to remove foreign body.
Case report:
First case was a 30-year-old man. He mentioned that USB cable wire, around one meter in length, was used to insert into urinary bladder via his urethra during masturbation. Abdominal X-ray was done, showing a tangled wire in the bladder. Bedside manual retrieval of wire was failed. Then emergent cystoscopy revealed a knotting wire that can not be removed. Open cytotomy was therefore performed for wire removal and cystorrhaphy was done finally. He recovered well without any associated complication after the surgery.
Second case was a 28-year-old man. He tucked multiple small magnetic beads into the urethra while masturbating. Abdominal X-ray confirmed multiple small beads arranged in a circle in the bladder. Emergent cystoscopic retrieval was done smoothly. He also recovered well after the surgery.
Discussion:
Cases with foreign bodies are rare. Majorly they were self-inflicted for sexual arousal. Wide ranges of materials including fishhooks, chopsticks, wire, beads, or even snake were reported before. Removal of the foreign body should be done as soon as possible to reduce risk of infection or urinary tract damage. Treatment methods, such as manual retrieval, endoscopic removal, and open cystotomy retrieval could be considered dependent on the size, location, mobility or the complexity of the foreign bodies.
Conclusion:
Foreign bodies in lower urinary tract were mostly self-inflicted and can be treated by manual, endoscopic method or open cystotomy surgery. After successful surgical treatment, most of the patient recovered well without long-term complication.