Foreign bodies in the urinary bladder and their management: A Pakistani experience

Abstract

Introduction: This was a retrospective study conducted to assess the nature, presentation, mode of insertion, diagnosis and management of foreign bodies in the urinary bladder. Methods: Between January 1998 and December 2007, 20 patients with foreign bodies in their urinary bladder were treated at our centre. The records of these patients were reviewed and analysed for their symptoms, mode of insertion, diagnosis, management and complications. Results: A total of 20 foreign bodies were recovered from the urinary bladders during the study period. These included JJ stents with calculi, intrauterine contraceptive devices with stones, a rubber stick, ribbon gauze, encrusted pieces of Foley catheter, proline thread with calculus, a suture needle, broken cold knives, the ceramic beak of a paediatric resectoscope, a knotted suprapubic tube, a hair clip, a nail, an electrical wire and a hairpin. The common presenting features were dysuria and haematuria. The diagnosis was established radiologically in most of the cases. The circumstances of insertion were variable; iatrogenic in 16 (80.0 percent) cases, sexual stimulation in two (10.0 percent), accidental insertion by a child in one (5.0 percent) and physical torture in one (5.0 percent). 17 (85.0 percent) foreign bodies were recovered endoscopically, and cystolithotomy was required in three (15.0 percent) patients. Conclusion: The instances of foreign bodies in the urinary bladder are uncommon. A diagnosis is usually made radiologically. Iatrogenic foreign bodies were found to be the most frequent type of insertion encountered. Endoscopic retrieval is usually successful, with minimal morbidity.