Todetermine the cause, clinical presentation and the most suitable method of treatment for retrieving foreign bodies from urinary bladder.
Patients and Methods
This descriptive study was conducted at Department of Nephro-Urology Chandka Medical College Hospital (CMCH), Larkana. Patients were divided into two groups on the basis of having known or unknown foreign bodies in urinary bladder. In group-1 the diagnosis of presence of foreign body was confirmed with the help of investigations, whereas in group-2 the foreign bodies were discovered incidentally either during cystoscopy or in the core of vesical calculus while doing intra-corporeal cystolithotripsy procedure. Patients presented with dysuria, frequency, suprapubic pain and hematuria. The foreign bodies with or without stone were approached for treatment via endoscopic or open surgical procedure.
34 cases having foreign body in urinary bladder were treated from April, 1998 to October, 2008. Group-I comprised of six (17.64%) patients, whereas group-II consisted of 28(82.3%) cases. The known foreign bodies included bullet (01, 2.94%), piece of metallic urethral dilator (01, 2.94%) and piece of Foleys catheter (04, 11.76%). The unknown foreign bodies were broken piece of balloon of Foleys catheter (13. 38.2%), suture material (10, 29.4%), thermometer (01, 2.94%), gauze piece (02, 5.88%), and IUCD (02, 5.88%). All the foreign bodies were removed by endoscopic approach except two (5.88%), who required open surgery.
Unusual foreign bodies like bullet, broken piece of metallic urethral dilator and thermometer were seen. Majority were retrieved by endoscopic method.
Foreign body, urinary bladder, hematuria.
Foreign body (FB) in the urinary bladder can be iatrogenic surgical complication and most common one is the abdominal sponge called Gossypiboma, with incidence of one per 1000-1500 laparotomies.1 The urethral foreign bodies have been reported since the earliest days of the medical literature.2 The types of foreign bodies have been classified as inserted, migratory and iatrogenic.3 Self-insertion of urethral FB is a common and objects are usually inserted via urethra for the purpose of eroticism, inquisitiveness and miscarriage or due to psychiatric illness, senility or alcoholism.4-6 Migration of intrauterine contraceptive device (IUCD) from the uterus to the pelvic cavity and sometimes into the urinary bladder has been reported.7 Although migrated un-absorbable suture materials from previous pelvic surgery are not only rarely reported complications,8,9 more recently, migration of surgical instrument from peritoneal cavity through the urinary bladder into the vagina and surgical sponge into urinary bladder six years after an inguinal hernioplasty was reported.10,11 Iatrogenic FB in urinary bladder are well known complications12,13 because of increased use or placement of artificial material within the urinary
Key words: Foreign body, urinary bladder, hematuria.