VARIOUS FOREIGN BODIES IN LOWER URINARY TRACT AND MANAGEMENT– A CASE SERIES

SOMANATHA SHARMA.S, JVS PRAKASH, VETRICHANDAR.S, ARASI KV, ARUN KUMAR PARANJOTHI, NATARAJAN.V
DEPARTMENT OF UROLOGY AND RENAL TRANSPLANTATION, GOVERNMENT STANLEY MEDICAL COLLEGE, CHENNAI, INDIA
CASE 2 – METAL WIRE AND CASE 5 – IATROGENIC FB IN
INTRODUCTION CASE 1 – A PANDORA’S BOX
MASTURBATION
CASE 4 – A PROLENE NOOSE
BLADDER FOR 10 YEARS
40 year old gentleman used metallic wire 40 years male, a daily wage worker 45 year old lady who had completed family
Foreign bodies in the lower urinary A 34 year-old gentleman presented to our undergone Copper T insertion 10 years back
for sexual gratification during admitted with h/o urgency, frequency and
OPD with c/o severe dysuria and and forgotten to remove it. She presented to
tract are relatively rare. These range masturbation and the wire went inside dysuria for 6 years . He had undergone
suprapubic pain following self insertion of our OPD with c/o increased frequency and
from tiny to large sizes, may be self- urethra. Presented with dysuria and mild emergency laparotomy 15 years ago for
a ball point pen into the urethra during occasional haematuria. General examination
inserted through the urethra, haematuria. On examination vitals were Intestinal obstruction and open
masturbation. On examination vitals were was normal. CT KUB revealed copper T inside
iatrogenic, migratory or due to essentially normal. Xray KUBU revealed cholecystectomy one year ago. Physical
essentially stable, abdomen was soft with bladder. Cystoscopy was done under
penetrating trauma. metallic wire in the anterior urethra. examination was unremarkable.
good bowel sounds. anaesthesia, Copper T was intact with
Under local anaesthesia, cystoscopy was Ultrasonography showed an echogenic,
It is inserted for the purpose of sexual Procedure: Under spinal anaesthesia, transverse limbs embedded in the bladder
performed and the FB was gently fixed intraluminal lesion in the bladder.
gratification. It may be also associated cystoscopy was performed and pen was
Upper tract was normal. Cystoscopic mucosa and vertical limb encrusted with
removed with cold cup forceps. Post op
with psychiatric disorders or senility. visualized. Using 22 F Nephroscope was secondary calculus. With lithotripter stone
Xray KUBU showed normal anatomy evaluation was performed under
Patient with lower tract FBs may be introduced per urethrally and the pen was was broken and with the help of grasper Cu T
without any residual ROS. Patient voiding anesthesia and confirmed presence of 2
asymptomatic or have complaints of successfully extracted using bi-prongs device was extracted in toto with minimal
well via naturalis. cm calculus formed around prolene knot
without any injury to urethra. The damage to bladder mucosa. Bladder filling
dysuria, haematuria, suprapubic pain, fixed to the bladder wall. These sutures
operative time was 45 mins without any done and no contrast leak noted on c-arm.
frequency, poor stream and urinary had been strangely included in the
intraoperative complications. 18 F Foley’s Post operative period was uneventful and
retention. bladder wall during midline laparotomy
catheter was left in situ for 14 days for patient voids well on follow up.
Some complications may be closure. Since the prolene knot was
adequate healing of urethra and bladder.
associated with long standing bladder attached firmly with the rectus sheath, we
Postoperative period was uneventful. CASE 3 – EDUCATE THE decided to open and cystolithotomy was
FBs as recurrent urinary tract infection UNEDUCATED done. Prolene suture was detached from
and stone formation. 50 year old gentleman underwent bladder. The bladder calculus was
Rarely some patients may develop emergency SPC in 2018 for AUR, had lost removed and analysis revealed calcium
serious complications such as follow up and landed in our emergency oxalate as composition. The suprapubic
perforation of the urinary bladder or with C/o urinary retention 2 years later. catheter and urethral Foley were removed REFERENCES
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