Unusual Intravesical Foreign Bodies and their Management
DOI:
https://doi.org/10.12970/2310-984X.2013.01.01.1Keywords:
Intravesical Foreign bodies, Foley’s Catheter Stem,DJ Stent, Rubber sheet, Metallic Coil Diagnosis, Management, Endoscopic Removal , Missed IUCD.Abstract
Objective: The objective of the study was to evaluate the difficulties in diagnosis and management of various intravesical foreign bodies. Material and Methods: Retrospective review of patients with unusual intravesical foreign bodies presented at department of urology, from January 1992 to August 2011.Their record were reviewed for age and sex, clinical presentation, investigations, and treatment offered. All patients underwent evaluation including history, physical examination, ancillary testing as indicated and subjective symptom appraisal. Results: Age of the 25 patients (male female ratio, 1.7:1) in study group varied from 1 to 65 years (mean age, 34.2 years). Nineteen patients (76%) had iatrogenic foreign bodies including retained corrugated rubber sheet in 1, a piece of a Foley balloon catheter in 7, cu- T wrongly put in urethra in 1 patient, cut end of Foley’s catheter in 3, fractured segment of Foley’s catheter in 1 patient, thread pieces in 1, Malecot rubber piece in 1and DJ stent in 4 patients. All of these patients had undergone some surgical intervention or urinary tract manipulation at peripheral hospitals and presented at variable intervals after the primary intervention. Four patients (16%) had migratory foreign body and 2 (8%) had self inserted foreign body. The most common presenting symptoms were urinary frequency, and dysuria. Endoscopic retrieval was possible in 11 (44.0%) patients, percutaneous cystolithalopaxy with removal of foreign body was possible in 7 (28%) and the remaining 7 (28%) underwent open cystostomy. None of the patients had any postoperative complications Conclusion: Intravesical foreign bodies should be included in the differential diagnosis of patients presenting with chronic/recurrent lower urinary tract symptoms after previous history of pelvic surgery, instrumentation or IUCD insertion. Radiological evaluation is necessary to determine the exact size, number, and nature of foreign bodies and associated complications like stones. Most intra vesical foreign bodies can be retrieved with endoscopic and minimally invasive techniques .References
[1] Pal DK. Intravesical foreign body. Indian J Surg 1999; 61: 381-3.
[2] Granados EA, Riley G, Rios GJ, Salvador J, Vicente J. Self introduction of urethrovesical foreign bodies. Eur Urol 1991; 19: 259-61.
[3] Eckford SD, Persad RA, Brewster SF, Gingell JC. Intravesical foreign bodies: five-year review. Br J Urol 1992; 69: 41-5. http://dx.doi.org/10.1111/j.1464-410X.1992.tb15456.x
[4] Mukherjee G. Unusual foreign body causing haematuria. J Indian Med Assoc 1974; 63: 284-5.
[5] Bartoletti R, Gacci M, Travaglini F, Sarti E, Selli C. Intravesical migration of AMS 800 artificial urinary sphincter and stone formation in a patient who underwent radical prostatectomy. Urol Int 2000; 64: 167-8. http://dx.doi.org/10.1159/000030521
[6] Tornero J, Palou J, Prados M, Salvador J, Vicente J. Bladder perforation caused by foreign body migration. Int Urol Nephrol 2000; 32: 241-3. http://dx.doi.org/10.1023/A:1007131017611
[7] Nouira Y, Rakrouki S, Gargouri M, Fitouri Z, Horchani A. Intravesical migration of an intrauterine contraceptive device complicated by bladder stone: a report of six cases. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18: 575-8. http://dx.doi.org/10.1007/s00192-006-0157-z
[8] Chamary VL. An unusual cause of iatrogenic bladder stone. Br J Urol 1995; 76: 138. http://dx.doi.org/10.1111/j.1464-410X.1995.tb07851.x
[9] Cardozo L. Recurrent intra-vesical foreign bodies. Br J Urol 1997; 80: 687. http://dx.doi.org/10.1046/j.1464-410X.1997.00468.x
[10] Grody MH, Nyirjesy P, Chatwani A. Intravesical foreign body and vesicovaginal fistula: a rare complication of a neglected pessary. Int Urogynecol J Pelvic Floor Dysfunct 1999; 10: 407-8. http://dx.doi.org/10.1007/s001920050070
[11] Gentle GP, Siegler AM. The misplaced or missing IUCD. Obstet Gynaec Survey 1977; 32: 627-47.
[12] Padya SV, Thakker N. lost IUD in bladder. J Obstet Gynaec 1989; 39: 440.
[13] Osborne JL, Bennett MJ. Removal of intraabdominal intrauterine contraceptive devices. Brit J Obstet Gynaec 1978; 85: 868-71. http://dx.doi.org/10.1111/j.1471-0528.1978.tb15845.x
[14] Aliabadi H, Cass AS, Gleich P, Johnson CF. Selfinflicted foreign bodies involving lower urinary tract and male genitals. Urology 1985; 26: 12-6.
[15] Ohashi H. A case of bladder calculus due to a ruptured balloon fragment of a Foley catheter. Hinyokika Kiyo 1997; 43: 227-8. Japanese.
[16] Persad RA, Paisley A, Smith PJ. Retained catheter tip causing recurrent urinary tract infection in a 91-yearold man. Br J Urol 1990; 66: 664. http://dx.doi.org/10.1111/j.1464-410X.1990.tb07211.x
[17] Prasad S, Smith AM, Uson A, Melicow M, Lattimer JK. Foreign bodies in urinary bladder. Urology 1973; 2: 258-64. http://dx.doi.org/10.1016/0090-4295(73)90460-3
[18] DiDomenico D, Guinan P, Sharifi R. Spontaneous expulsion of an intravesical bullet. J Am Osteopath Assoc 1997; 97: 415-6.
[19] Roemer KR, Das S. Transurethral endoscopic removal of cylindrical intravesical body. Urology 1984; 23: 592-3. http://dx.doi.org/10.1016/0090-4295(84)90079-7
[20] Scriven JM, Patterson JE. Extraction of an intravesical thermometer using a flexible cystoscope. Br J Urol 1995; 76: 815.
[21] Wegner HE, Franke M, Schick V. Endoscopic removal of intravesical pencils using percutaneous nephrolithotomy sheath and forceps. J Urol 1997; 157: 1842. http://dx.doi.org/10.1016/S0022-5347(01)64878-X
[22] Pal DK, Bag AK. Intravesical wire as foreign body in urinary bladder. Int Braz J Urol 2005; 31: 472-4. http://dx.doi.org/10.1590/S1677-55382005000500010
[23] Eshiobo I, Peter I, Emeka K, Vincent O. Intravesical foreign bodies: a case report and a review of the literature. Int Med Case Reports J 2011; 4: 35-39.
[24] Reddy BS, Daniel RD. A novel laparoscopic technique for removal of foreign bodies from the urinary bladder using carbon dioxide insufflation. Surg Laparosc Endosc Percutan Tech 2004; 14: 238-9. http://dx.doi.org/10.1097/01.sle.0000136683.07990.7f
