Self-inflicted Foreign Bodies Research Articles

Intravesical foreign body: our experience of diagnostic clue and management.

Background: The study aims to evaluate the clinical presentation, type of foreign body, mode of insertion, and management of intravesical foreign bodies in patients treated at our hospital. Material and Methods: This was a retrospective study conducted between January 2019 to December 2020. Twelve patients underwent treatment for an intravesical foreign body at Srirama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, India.. Results: A total of twelve patients were treated for a foreign body in the urinary bladder. All the patients vary in age group starting from 20 to 72 yrs. Among the total of twelve patients, 5 were female whereas 7 were male patients. Patients were presented with the symptoms like dysuria, frequency, hematuria, lower abdominal pain, burning micturition. Among these twelve patients, two patients had self-inflicted foreign bodies, one pencil and the other was a stick. One patient had thread, and two female patient had IUD.The remaining 7 patients were old aged male had a piece of foley catheter in the urinary bladder. Among all these 12 patients, only two patients were treated with open procedure i.e suprapubic cystolithotomy as foreign bodies (IUD and piece of foley) lead to calculus formation over it. Rest all patients were treated with endoscopic removal of a foreign body under either local anaesthesia or Spinal anaesthesia. Conclusions: Endoscopic retrieval of Foreign Body is always preferred and safe approach. Removal of the foreign body without injury to the urinary bladder or the urethra gives a good outcome.

Unusual self-inflicted foreign bodies in the urethra

Self-inflicted urethral foreign body insertion in men is very rare and an important condition which urologists encounter in their clinical practice. Urologists should be familiar with the different techniques for the removal of these foreign bodies. Most cases are associated with psychiatric disorders. Hence, they should be referred for complete psychiatric evaluation. The emotional condition of the patient and the circumstances under which this act was committed should be investigated at the same time. Many cases of self-inflicted foreign body in the urethra have been reported in the literature such as fishhooks and bullets. However, metallic tongue cleaner in urethra has not yet been reported. Here, we are reporting the case of a 28-year-old male who presented with dysuria for 1 day following insertion of metallic tongue cleaner in the penile urethra, for sexual gratification which, he was unable to remove. The foreign bodies were found in the anterior urethra on X-ray and were successfully removed endoscopically without any complication. The patient was advised to take psychiatric consultation and counseling to prevent future episodes.

Electrical Wire as a Foreign Body in a Male Urethra : A Case Report

Self-inflicted foreign bodies in the male urethra and urinary bladder are an emergency that urologists may rarely have to face. A case of an electrical wire inserted in the male urethra and coiled in the bladder is presented here. A 33-year-old male presented with the inability to void and bloody urethral discharge after having introduced a long electrical wire in his urethra for masturbation 6 hours earlier. He had made several unsuccessful attempts to remove it. We know that variety of these objects may be impressive and removal of the foreign body may be quite challenging requiring imagination and high-level surgical skills. In this case an electrical wire was used and the diagnostic as well as the therapeutic steps for its removal are presented here. Bangladesh Journal of Urology, Vol. 14, No. 2, July 2011 p.62-64

Self-inflicted urethral and vesical foreign bodies – Case report

Foreign bodies in the lower urinary tract are rare with self-infliction for sexual gratification as the commonest reason. Presenting complaints are lower urinary tract symptoms, abdominal pain, and haematuria. We report two cases of self-inflicted foreign bodies in the lower urinary tract of adult male patients; one by an electrical wire and another by Bengal grams. Bengal gram as the foreign body has never been reported previously. X-ray, ultrasound, and computed tomography of the KUB region help to confirm the diagnosis. The primary goals of treatment are safe removal of foreign bodies, avoiding iatrogenic injuries to the lower urinary tract, and preservation of the sexual function. Endoscopic management is the commonest procedure performed and described in such cases. We were able to manage both cases endoscopically. Psychiatric consultation and appropriate counselling should be given to prevent further repetitions of such acts in the future.

Self-Inflicted Foreign Bodies around the Male Genitalia

A great variety of self-inflicted foreign bodies have been removed from the lower urinary tract and male external genitalia. These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Most patients present when complications had occurred from the foreign body such as difficulty in passing urine, haematuria, extravasations, pain or swelling of the external genitalia and abscess formation. Three young patients who applied metallic foreign bodies around their genitals will be presented. The symptoms, findings and surgical management will be presented.

Self-inflicted foreign bodies in lower genitourinary tract in males: Our experience and review of literature.

Objectives:To study retrospectively the frequency, demographic, phenomenological, and psychiatric profile in patients presented with self-insertion of foreign bodies in the lower genitourinary tract in our institute.Materials and Methods:From January 2009 to 2015, the records of patients admitted with self-insertion of foreign bodies into the lower urinary tract were analyzed retrospectively regarding demographic and phenomenological profile, the mode of presentation, diagnosis, management, complications, and possible contributing factors leading to the event.Results:Out of 17,978 inpatients, ten patients (0.055%) presented with foreign body insertion in the lower genitourinary tract in last 6 years. Mean age was 28.1 ± 13.9 (7–50) years. Objects used for insertion were varied from seeds, twigs to the electric wire. The contributing factors were lack of partner, misconception about masturbation, and underlying psychiatric illness. The presenting symptoms were pain and swelling of the penis, difficulty in voiding, and skin ulceration. The diagnosis was possible by simple observation in four patients, X-ray kidney, ureter, and bladder, and sonography of the pelvis in six patients. Five patients had endoscopic retrieval of foreign body, 2 had an open, suprapubic cystotomy, urethrotomy was needed in one patient, and forceps removal in two patients. There were no postoperative complications. Psychiatric profile was evaluated in nine patients.Conclusions:Foreign body insertion to lower urinary tract was rare. A main cause for insertion of foreign bodies was autoerotism, misconceptions regarding masturbation, and underlying psychiatric illness. In addition to suitable method of surgical removal, counseling and psychiatric evaluation are necessary to prevent recurrences or for early detection of psychiatric problems.

Comparison of surgical intervention and non-surgery result in early prostate cancer

s / Urological Science 26 (2015) S50eS81 S57 The operation began with 7ecm midline incision above the umbilicus. A small hole of cystic wall was created and more than 6 L of yellowish clear fluid was drained. The hand-assisted device was placed in midline wound. While other two 10-mm trocar were placed in left lower abdomen and left anterior axillary line subcostally. The membrane of cyst was dissected as much as possible. Nephropexy was done to attach migrating left kidney to the back of the abdominal wall. The postoperative course was uneventful and the patient was discharged 3 days after the operation. Intravenous urography done 3 months later showed normal kidney position and bilateral patent ureters. Discussion: A huge renal cyst measuring more than 15 cm is an extremely rare. Cases presenting simply with progressive abdominal distention can lead to misdiagnosis, such as obesity or ascites. In our case, huge left renal cyst caused left kidney migration to right side, leading to initial misdiagnosis of right acute pyelonephritis. Surgery has been considered the mainstay of treatment for giant cyst. We performed hand assisted laparoscopic renal cyst unroofing and nephropexy with uneventful postoperative course and good outcome. NDP028: UNUSUAL URETHRAL FOREIGN BODIES Wei-Chung Hsiao , Sung-Lang Chen , Yu-Lin Kao , Wen-Jung Chen , Tzuo-Yi Hsieh , Shao-Chuan Wang . Division of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan; 2 Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Purpose: Urethral foreign bodies are uncommon clinical conditions. Most of the foreign bodies are self-introduced under the circumstances of autoerotic impulses, sexual curiosity, psychiatric illness, or rarely migration from adjacent organs. Retrieval of the urethral foreign body is casespecific due to wide variety of foreign bodies. Materials and Methods: A 75-year-old man was sent to emergency department after a motorcycle accident. Serial examinations including pelvic radiography and computed tomography discovered 5 fishhooks within the urethra unexpectedly. Ingrowth into urethral mucosa of the fishhooks with related inflammatory process was noted. Due to complexity of the fishhook position and pelvic fracture condition, cystourethroscopic retrieval of the foreign bodies was performed successfully in a two-step manner. Results: Self-inflicted urethral foreign bodies have a very low incidence. Major complications of urethral foreign bodies include trauma, infection, urine retention, and urethral stricture. Most of the foreign bodies of lower urinary tract can be treated with endourological modalities. The key point of urethral foreign body extraction relies on its physical attributes and morphology with the purpose of minimal urothelial injury. Conclusion: The urethral foreign bodies could be removed successfully by cystourethroscopic procedure without any complication, even in the presentation of mucosal ingrowth.

Unusual cause of urethral bleeding in an adolescent: a case in dilemma

Numerous cases of self-inflicted foreign bodies in the male urethra have been reported. A case of a self-inflicted urethral injury or hemangioma in an adolescent that presented a dilemma is described here. An adolescent male of 14 years presented with a complaint of intermittent urethral bleeding for a week. He attributed this to blunt trauma sustained while playing in school. On examination, there was no sign suggestive of any trauma or any abnormal lesion on the genitalia or surrounding area. On cystourethroscopy, there was a solitary hemorrhagic lesion of 0.5 cm with a bluish base on the ventral surface of the pendular urethra, 1 cm proximal to the fossa navicularis, which was ablated using Ho:YAG laser fiber (365 μm) through a working channel mounted in an OIU (optical internal urethrotomy) sheath. The absence of any sign of external trauma or presentation after 1 week of the incident suggests an element of falseness in the history. It may be due to embarrassment or fear, which contributes to self-insertion of foreign bodies into the urethra as the primary cause, especially in adolescent males. However, the trauma can be coincidental, with the bleeding of the urethra caused by a urethral lesion like a hemangioma and might present after a long gap of 1 week due to a lack of understanding or lack of severe symptoms. Most patients of self-inflicted injuries are too ashamed to admit that they inserted any object. A psychiatric evaluation is recommended for all these adolescents, with appropriate medical therapy when indicated.

Unusual Penetrating Injury to the Male Genitalia

Various self-inflicted foreign bodies have been removed from the lower urinary tract and external male genitalia. In many cases foreign bodies were inserted or applied for autoerotic reasons which are frequently associated with mental health disorders. Here the author reports an unusual case of self insertion of a 6-cm long metal needle at penoscrotal junction of the erect penis for sexual pleasure. The stitching needle was inserted by a 20-year old male who was too ashamed to admit the motive at first. The caudal end of the needle was palpable at the root of the penis as it was below the urogenital diaphragm. The needle was successfully removed under fluoroscopic guidance with minor surgical exploration and with no complications.

Self-Inflicted Urethrovesical Foreign Bodies in Children

We present two cases of self-inflicted urethrovesical foreign body in children. Case 1 was a 6-year-old girl admitted with a history of self-introduction of a pin. The X-ray revealed the pin as 3.5 cm in length and in the bladder. The foreign body was removed endoscopically. Case 2 was a 13-year-old boy with a self-introduced packing needle, 13 cm in length, partially in the urethra. The end and the tip of the needle passed through the urethra to the surrounding tissues. Foreign body removed via a little skin incision with endoscopic guidance. Foreign bodies are rarely found in the lower urinary tract of children. Definitive treatment is usually the endoscopic removal; however, sometimes surgical intervention may require.

Allen key completely in male urethra: a case report

IntroductionVarious cases of self-inflicted foreign bodies in the male urethra have been reported. Most of them are associated with autoerotic stimulation, psychiatric disorders or intoxication.Case presentationWe report the first case of a patient who put an Allen key completely in his urethra. The patient presented with dysuria, haematuria and penile pain.ConclusionA self-inflicted urethral foreign body is a rare situation. Endoscopic removal is the recommended first-line treatment and if unsuccessful, open procedures may be necessary.

Unusual Foreign Body In Urinary Bladder: A Case Report

Introduction: A great variety of self-inflicted foreign bodies have been removed from the lower urinary tract and male external genitalia. Our case is a peculiar one. No such foreign body in urinary bladder has been reported so far in the literature. Case Presentation: A 14 year old boy came to us with complaints of pain, difficulty in voiding with dribbling of urine and subsequently developed acute urinary retention of 24 hours duration. On further questioning he gave an interesting history. While he was cleaning the fish tank in his house, he was holding a fish in his hand and went to the toilet for passing urine. While he was passing urine, the fish slipped from his hand and entered his urethra and then he developed all these symptoms. . Plain X ray KUB was normal. Abdominal Ultrasonogram showed normal kidneys, bladder was full and a 1.5 Cm echogenic object found inside the bladder without any after shadow. Management: With 19F cystoscopic sheath and 30 degree scope, cystourethroscopy was done. His urethra was normal. There was about 2 Cm long dead fish found inside the bladder. We tried to remove with biopsy forceps but unable to hold because of the smooth surface. Then we introduced rigid ureteroscope and with the help of stone grasper the fish was removed in Toto. Conclusion: Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimize bladder and urethral trauma. The possibility of an intravesical foreign body should be considered in any patient with chronic unexplained lower urinary tract symptoms.

Self-Inflicted Male Urethral Foreign Body Insertion: Endoscopic Management and Complications

OBJECTIVE To evaluate the cause, diagnosis, management and complications of self-inserted urethral foreign bodies in men, reviewing a 17-year experience. PATIENTS AND METHODS From November 1986 to January 2004, 17 men were treated for self-inflicted urethral foreign bodies; the records were analysed retrospectively for presentation, diagnosis, management and complications. RESULTS In all 17 patients the foreign bodies were clearly palpable. Objects included speaker wire, an AAA battery, open safety pins, a plastic cup, straws, a marble, and a cotton-tipped swab. The most common symptom was frequency with dysuria, but there was sometimes gross haematuria and urinary retention. The cause for inserting the foreign body varied; psychiatric disorder was the most common, followed by intoxication, and erotic stimulation was the cause in only five patients. All patients had diagnostic imaging; plain pelvic images were sufficient in 14, ultrasonography or computed tomography was needed in three. Endoscopic retrieval was successful in all but one patient, where a perineal urethrotomy was required. The most common complications were mucosal tears and false passages. Urethral strictures were associated with multiple attempts to insert the foreign body. CONCLUSION Self-inflicted urethral foreign-body insertion in men is unusual. A radiological evaluation is necessary to determine the exact size, location and number of foreign bodies. Endoscopic retrieval is usually successful, and antibiotic coverage is necessary. A psychiatric evaluation is recommended for all patients, with appropriate medical therapy when indicated. Late manifestation has included urethral stricture disease, and a close follow-up, albeit difficult in these patients, is desirable.

Self-inflicted foreign bodies involving lower urinary tract and male genitals

A great variety of self-inflicted foreign bodies have been removed from the lower urinary tract and male external genitalia. These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Most patients were too ashamed to admit they had inserted or applied any object and usually presented when a complication had occurred from the foreign body such as difficulty voiding, hematuria, pain or swelling, extravasation, or abscess formation. Inspection and palpation diagnosed foreign bodies involving the male external genitalia in 3 patients and anterior urethra in 6. Radiographic studies with and without contrast medium and endoscopy were required to diagnose foreign bodies in the posterior urethra and bladder in 9 patients, and the exact location, shape, and orientation of the foreign bodies in all sites, radiolucent objects, and the complications of mucosal laceration and extravasation. All 16 foreign bodies in the anterior urethra (below urogenital diaphragm) were removed by endoscopic manipulation in the 6 patients. Nine foreign bodies in the posterior urethra or bladder (above the urogenital diaphragm) were removed by endoscopic manipulation in 2 females and 2 males, while suprapubic cystotomy was required in I female and 4 males. The 3 foreign bodies applied to the external genitalia of 3 males were removed carefully to avoid injury to the underlying skin. Foreign bodies lying below the urogenital diaphragm were palpable and readily removed endoscopically while foreign bodies above the urogenital diaphragm required greater endoscopic manipulation or open surgical procedures.