Intravesical Foreign Body Research Articles

Magnetic beads as intravesical foreign bodies

Magnetic beads as intravesical foreign bodies

Rare foreign body in bladder

Rationale:The bladder is the most common site of foreign bodies in the urinary tract. Presenting complaints in patients with a foreign body are urinary retention, dysuria, frequent urination, decreased urine volume, nocturia, hematuria, painful erection, as well as pain in the urethra and pelvis.Patient concerns:A 50-year-old married male presented with complaints of severe lower abdominal pain and dysuria.Diagnoses:A plain radiograph of the pelvis showed a metallic dense foreign body that was composed of many small magnetic balls in the pelvic region.Interventions:The foreign body was removed under cystoscopy, and 67 magnetic balls were detected without any surgical or postsurgical complications.Outcomes:During operation, A cystoscopic examination confirmed no residue.Lessons:The bladder is the most common site of a foreign body in the urinary tract.Most intravesical foreign bodies can be removed transurethrally and with minimum access. The best mode of management depends on the nature of the foreign body, lodged site, expertise of the surgeon, and available instruments.

Intravesical foreign body in a 12-year-old boy

Self-insertion of foreign body in lower urinary tract is rare in children. It is commonly seen in adults. The reason for self-insertion may be accidental, due to psychiatric illness, curiosity, sexual stimulation or therapeutic in cases of stricture. Most of the cases reported are in adults. Here we present a 12-year-old child presenting with self-insertion of metallic hair pin into the lower urinary tract with symptoms of dysuria and retention of urine. X-ray and ultrasonography were diagnostic modalities which aided in the diagnosis. The child underwent successful cystoscopic removal of foreign body after thorough investigation. Post removal child underwent psychiatric evaluation. He was not suffering from any psychiatric condition. He admitted having inserted the hair pin out of curiosity. Child was passing urine in good stream at time of discharge. At six months follow up child remains asymptomatic.

Intravesical foreign body: The forgotten and forsaken diagnosis? a case report and review

Intravesical foreign body: The forgotten and forsaken diagnosis? a case report and review

A forgotten intravesical foreign body. A not so unusual story

We report the case of a 67 - year - old woman who presented with recurrent lower urinary tract symptoms due to bladder calculus that formed around a ureteral stent that was inserted into her drainage system during stone removal surgery from the renal pelvis 6 years previously. In this paper we present the evaluation, imaging and management of the above case. Our patient’s case was unique for the length of time (6 yr) from foreign body insertion to presentation. Αναφέρουμe την πeρίπτωση μίας 67χρονης γυναίκας μe υποτροπιάζoντα eνοχλήματα από το κατώτeρο ουροποιητικό που οφeίλονταν σe λίθο της ουροδόχου κύστης που σχηματίστηκe γύρω από ένα ουρητηρικό καθeτήρα που eισήχθη στο αποχeτeυτικό σύστημα του δeξιού νeφρού της κατά τη διάρκeια χeιρουργικής eπέμβασης αφαίρeσης λίθου από τη νeφρική πύeλο πριν από 6 χρόνια. Σe αυτό το άρθρο παρουσιάζeται η αξιολόγηση, η απeικόνιση και η διαχeίριση της παραπάνω πeρίπτωσης. Αυτή η πeρίπτωση eίναι μοναδική για το χρονικό διάστημα (6 έτη) από την eισαγωγή στην του ξένου σώματος έως την παρουσίαση της στο νοσοκομeίο.

Foreign Bodies in the Urinary Bladder and Their Management: A Single-Centre Experience From North India.

PurposeThis study was performed to characterise the nature, clinical presentation, mode of insertion, and management of intravesical foreign bodies in patients treated at our hospital.MethodsBetween January 2008 and December 2014, 49 patients were treated for intravesical foreign bodies at King George Medical University, Lucknow. All records of these patients were retrospectively analysed to characterise the nature of the foreign body, each patient’s clinical presentation, the mode of insertion, and how the case was managed.ResultsA total of 49 foreign bodies were retrieved from patients’ urinary bladders during the study period. The patients ranged in age from 11 to 68 years. Thirty-three patients presented with complaints of haematuria (67.3%), 29 complained of frequency of urination and dysuria (59.1%), and 5 patients reported pelvic pain (10.2%). The circumstances of insertion were iatrogenic in 20 cases (40.8%), self-insertion in 17 cases (34.6%), sexual abuse in 4 cases (8.1%), migration from another organ in 4 cases (8.1%), and assault in 4 cases (8.1%). Of the foreign bodies, 33 (67.3%) were retrieved by cystoscopy, while transurethral cystolitholapaxy was required in 10 patients (20.4%), percutaneous suprapubic cystolitholapaxy was performed in 4 patients (8.1%), and holmium laser lithotripsy was performed in 2 patients (4.08%).ConclusionsForeign bodies should always be included in the differential diagnosis when evaluating a patient who presents with chronic lower urinary tract symptoms. A large percentage of foreign bodies can be retrieved using endoscopic techniques. Open surgical removal may be performed in cases where endoscopic techniques are unsuitable or have failed.

‘Blu-Tack’ as an intravesical foreign body: Overcoming a sticky situation

Intravesical foreign bodies can pose a significant urological challenge. An unusual intravesical foreign body described within the literature is ‘Blu-Tack’. This unique material with its distinct physical properties presents a particular challenge in its management. We describe our novel endoscopic approach to the removal of an intravesical ‘Blu-Tack’ mass and suggest this method as a means of facilitating successful extraction of this particular foreign body.

8: Use of suprapubic carter-thomason needle to assist in cystoscopic excision of intravesical foreign object

We present a video of a minimally-invasive technique using the Carter-Thomason Needle Suture Passer for suprapubic assistance in the cystoscopic removal of the intravesical eroded suture. Suture injury to the bladder occurs in 0.6% of cases of retropubic bladder neck suspension procedures (1). These injuries can occur from inadvertent placement of the sutures through the bladder at the time of surgery or postoperative erosion or migration of the sutures into the bladder, and can lead to chronic inflammatory reaction in the wall of the bladder and stone formation. Common symptoms are of urinary frequency, urgency, urinary tract infection, voiding difficulty and pelvic pain. Intraoperative cystoscopy detects some, but not all, suture bladder injuries. It is therefore important to exclude intravesical foreign body in patients with lower urinary tract symptoms and a history of bladder neck suspension. We describe a case of a 63 year old woman with symptoms of recurrent urinary tract infections, urinary frequency, urgency, hesitancy, dysuria, microscopic hematuria and pelvic pain. She underwent a ‘bladder suspension’ 23 years prior for stress urinary incontinence, which she reported as being uncomplicated. Pelvic ultrasound demonstrated a 2cm bladder calculus. Office cystoscopy revealed a 3cm stone-encrusted suture erosion of the bladder. The use of a Carter-Thomason Needle Suture Passer for suprapubic assistance in the cystoscopic removal of intravesical suture is a minimally invasive surgical technique that can be applied to removal of other foreign objects, such as mesh. Compared to suprapubic trocars, prolonged catheterization and follow-up cystogram are not necessary.

Migrated Intravesical Foreign Bodies: A Five Year Review

Introduction: Migratory foreign bodies make a separate group of intravesical foreign bodies and any object in vicinity of bladder may migrate into it. Material and methods: Retrospective analysis of migratory intravesical foreign bodies which were treated over last five year, done and discussed with the available literature. Results: Different foreign bodies reported to migrate into the bladder through different route. In most of the cases, they present with minimal lower Urinary Tract Symptoms (LUTS) which are often ignored by patients and clinicians; and it is the haematuria which draw medical attention. With time they encrustate into stone but rarely seen to migrate further. Conclusion: Almost any foreign body in lower abdomen may migrate into urinary bladder through almost any possible route, from where they rarely migrate further. Bladder remains as an ideal receptacle to retain them for long with encrustation.

Intravesical foreign body and transitional cell carcinoma in a dog

A nine-year-old chemically neutered male hovawart was referred due to dysuria, stranguria, haematuria and inappetence. Initial examinations suggested a transitional cell carcinoma of the urinary bladder with pulmonary metastases and...

Management of intravesical self-inflicted sharp objects in children: 10-year single-center experience

Intravesical foreign bodies (FBs) are rare and have interesting pathology for urologists. There has been an increase in reports of intravesical FBs in the last few decades, but they are still considered to be rare in children, especially young girls. Here we present our experience in the assessment and management of intravesical self-inserted sharp objects in children. We reviewed the records of children with self-introduced intravesical FBs admitted to our hospital during the last 10 years. Twenty-four cases were included in this study (20 girls and 4 boys). The presenting symptoms and methods of diagnosis and treatment were reviewed. The ages of the patients ranged from 4 to 12 years. In all cases, foreign bodies were self-inserted. All patients were subjected to KUB (kidney, ureter, bladder radiograph) and abdominal ultrasonography. Based on the KUB findings, the FBs in girls were found to be metal pins in 12, a hair clip in four, and a wooden pencil in three (Figure). In boys, a coiled electric wire was found in three, with a urinary calculus formed over one of them. There were small metallic objects in two cases (1 boy and 1 girl). Endoscopic removal of FBs was done successfully in 19 cases (18 girls and 1 boy), and open cystostomy was performed in four cases (3 boys and 1 girl). Intravesical FBs are important considerations in the differential diagnosis of pathological lower urinary tract symptoms. They represent significant challenges to urologists. Among children, the reasons for self-insertion of FBs might reflect psychiatric disorders. Routine psychiatric evaluations should be offered to all patients with intentional FB insertion to avoid missing any underlying psychiatric disorders. In our study, psychiatric evaluations have been advised for all the affected children and their parents. Self-inserted FBs are commonly seen in adults and are rarely encountered in children. To our knowledge, this is the largest reported series of children with self-inflicted intravesical FBs. In addition, all of the FBs in this study had one or more sharp edges that made their endoscopic extraction more difficult without causing bladder or urethral damage. In children, removal of intravesical FBs represents a great challenge, as the size of the pediatric urethra may hinder safe transurethral removal. Endoscopic handling of intravesical FBs is mostly unsuccessful in boys because of the long and narrow urethra, and open cystostomy might be the treatment of choice to save the urethra. In contrast, the short female urethra renders the endoscopic removal of intravesical FBs more successful. In this study, endoscopic removal of FBs was done successfully in 19 cases (18 girls and 1 boy), and open cystostomy was performed in four cases (3 boys and 1 girl). Although FBs in the urinary tract of children are very rare, they need to be considered during any evaluation of pathological lower urinary tract symptoms. Endoscopic management is feasible for most of these patients. The size, number, nature of foreign bodies, and any associated urinary calculi determine the treatment modality.

An Iatrogenic Intravesical Foreign Body, a Piece of Foley Catheter: Case Report

Although the cases of intravesical foreign body are rare, it should always be considered in the differential diagnosis of patients presenting with lower urinary tract symptoms. In general, introduction of foreign bodies into the bladder may be self- insertion through the urethra, iatrogenic, migration from adjacent organ or a result of trauma. Here we evaluated a case of intravesical foreign body that emerged following removal of a catheter was evaluated in the light of current literature. (JAREM 2014; 2: 79-81)

An Unusual Intravesical Foreign Body for Abortion Attempt. About a Case Report at Bobo Dioulasso University Teaching Hospital (Burkina Faso) and Literature Review

We reported a case of an intravesical foreign body in a 16 years old teenager for abortion attempt. During laparotomy for suspected pelvic appendicitis, we incidentally discovered an intravesical foreign body. From this first observation in our urology division, we reviewed the literature on the nature and circumstance of self introduction in bladder of foreign body and their surgical ablation. We emphasized the importance of endoscopy as a support of diagnosis and therapeutic of intravesical foreign body. This observation also highlighted the lack of information in our teenagers about reproductive and sexual health.

Lower urinary tract dysfunction resulting from a 10-year retained intravesical absorbable suture from a uterine myomectomy

Intravesical foreign bodies may be a result of migration from adjacent organs or penetrative injury, or they may be self-introduced or iatrogenic from medical or surgical procedures. Urinary tract infections, abnormal biochemistry, abnormal urinary tract anatomy, and the presence of foreign bodies within the urinary tract have been identified as risk factors for bladder stone formation [1]. There have been reports of bladder stones associated with a foreign body in patients who had a pelvic organ surgery previously [2] .T he foreign body acts as a site for encrustation and calculi formation [3]. Patients may be asymptomatic or may show some mild discomfort. Common symptoms are hematuria, dysuria, voiding difficulties, increased urinary frequency, and a weak urinary stream. A 50-year-old patient presented to our unit with complaints of intermittent lower abdominal pain. She complained of lower urinary tract symptoms, predominantly a weak urinary stream and voiding difficulties. Ten years earlier, she had a uterine myomectomy. However, postoperatively, she developed complications due to tuboovarian abscess that required a re-laparotomy. She also had a history of hypertension that was well controlled with medications. She had had three vaginal deliveries with no complications. Her body mass index was 38.2 kg/m 2 . Upon pelvic examination, no abnormal findings were noted. A urine culture did not show infection. An upright abdominal and pelvic X-ray revealed a radio-opaque density or calcification over the right ureteric orifice (Fig. 1). There was also mild scoliosis of the lumbar spine. We performed a scheduled cystoscopic examination. We removed a 1.5 cm 0.9 cm bladder stone and noted an abnormal foreign body at the bladder dome. The features of the foreign body were suggestive of a potential mesh material (Fig. 2). The patient’s symptoms improved after the cystoscopy, but prior to any further intervention, we performed further evaluation of the foreign body with a computed tomography scan of the pelvis. The results showed normal pelvic organs with no evidence of a foreign body. We counseled the patient, and she underwent another cystoscopic examination. Transurethral removal of the suture with endoscopic forceps was performed while the patient was under general anesthesia. No complications were encountered. The bladder mucosa was inspected (Fig. 3). The foreign body disintegrated upon examination. A histological analysis confirmed the foreign body as a suture material with granulomatous reaction and inflammatory granulation tissue. The patient had an indwelling bladder catheter for 1 day and had an excellent recovery. At the 2 months’ postprocedure follow-up, the patient was symptom free, and a repeat cystoscopic examination revealed normal findings. In animal and clinical studies, it has been reported that foreign bodies can act as a nidus for stone formation [4]. Bladder stone formation has been reported to occur on exposed nonabsorbable sutures and mesh [2,3,5]. There are very few reported cases of stone formation on absorbable sutures [1,6]. In our case, it may be possible that during surgery for the uterine myomectomy or during the second surgery, the suture was passed inadvertently into the bladder dome. The removed foreign body was confirmed to be a suture material. We believe that this foreign body is a remnant of the suture used in the patient’s surgical procedure 10 years ago. In this case, the suture may be a contributing factor to the development of bladder calculi and may be the cause of the

Intravesical foreign body–induced bladder calculi resulting in obstructive renal failure

We report the case of a 30-year-old man who presented with obstructive renal failure and urosepsis due to bladder outlet-obstructing bladder calculi that formed around 3 copper wires that were self-inserted into his urinary bladder 15 years previously. We present the evaluation, imaging and management of the unique complications resulting from the self-insertion of an intra-vesical foreign body. Our patient's case was unique for 2 reasons. First, the length of time (15 yr) from foreign body insertion to presentation is the longest interval reported in the literature. Second, this is the first report of bladder calculi induced by the insertion of a foreign body that resulted in obstructive renal failure.

Intravesical Foreign Body: A Case Report

Foreign body in the urinary bladder is not very common. It may occur by self insertion or migration from neighboring organs. It represents a urologic challenge which requires prompt management and should be treated as emergencies. Most of the foreign bodies in the urinary bladder can be successfully removed endoscopically. Sometimes open surgical procedure may require in removing the foreign body. Removal of foreign body from urinary bladder may be quite challenging requiring imaginations & high level surgical skills. Here we reported a case of 29 years old mentally retarded man with an intravesical foreign body. We successfully removed the foreign body by endoscopic procedure under general anesthesia. In post operative follow up there was no voiding problem & patient was advised for psychiatric consultation.
 JCMCTA 2012 ; 23 (2): 47-49

Complete endoscopic management of a retained bullet in the bladder

A 25-year-old male gunshot victim presented at our institution with gross hematuria following Foley catheter insertion. Computed tomography and cystogram did not show a bladder perforation, but were notable for a left ischial fracture and the presence of a bullet within the bladder. After failed attempts at retrieving the bullet with a resectoscope and loop, as well as a cystoscope and stone crusher, a 26 French nephroscope was inserted transurethrally, and the bullet was successfully engaged and removed using a Perc NCircle (Cook Medical, Bloomington, IN) grasper. The extra-peritoneal injury was managed conservatively with catheter drainage. To our knowledge, this represents the first case of successful transurethral management of a retained intravesical bullet. Such an approach may benefit patients with retained intravesical bullets or other challenging intravesical foreign bodies and may be helpful in select circumstances to spare patients from more extensive surgeries.

Open removal as a first-line treatment of magnetic intravesical foreign bodies.

Intravesical foreign bodies are an uncommon, but significant, cause of urologic consultation. We present 3 patients who all inserted magnetic beads per urethra into the urinary bladder, which subsequently became retained. Endoscopic attempts were unsuccessfully tried in the first 2 cases, necessitating open cystotomy to remove the beads. The third went straight to open removal. Given the failure of minimally invasive techniques, we believe that open removal should be the first-line treatment for these types of foreign bodies.

Open removal as a first-line treatment of magnetic intravesical foreign bodies

Intravesical foreign bodies are an uncommon, but significant, cause of urologic consultation. We present 3 patients who all inserted magnetic beads per urethra into the urinary bladder, which subsequently became retained. Endoscopic attempts were unsuccessfully tried in the first 2 cases, necessitating open cystotomy to remove the beads. The third went straight to open removal. Given the failure of minimally invasive techniques, we believe that open removal should be the first-line treatment for these types of foreign bodies.

Unusual Intravesical Foreign Bodies and their Management

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 . Keywords: Intravesical Foreign bodies, Foley’s Catheter Stem,DJ Stent, Rubber sheet, Metallic Coil Diagnosis, Management, Endoscopic Removal , Missed IUCD. Read more →