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膀胱内异物:综述及当前管理策略

Intravesical foreign bodies: review and current management strategies.

作者信息

Rafique Muhammad

机构信息

Department of Urology, Nishtar Medical College, Multan, Pakistan.

出版信息

Urol J. 2008 Fall;5(4):223-31.

Abstract

INTRODUCTION

The aim of this study was to evaluate the cause, diagnosis, and management of intravesical foreign bodies in patients treated at our hospital and to review and update management of intravesical foreign bodies reported in the current literature.

MATERIALS AND METHODS

Sixteen patients had been treated for intravesical foreign bodies at Nishtar Medical College Hospital, Multan, Pakistan during a 5-year period. Records of these patients were analyzed retrospectively for etiology, presentation, diagnosis, and management.

RESULTS

The age of the patients ranged from 14 to 70 years and 10 of them were men. Seven patients (43.8%) had iatrogenic intravesical foreign bodies, 5 (31.3%) had migrated foreign bodies from the adjacent organs, and 4 (25.0%) had self-introduced foreign bodies into the bladder. The objects included copper wire, carrot, lead pencil, intrauterine device, surgical gauze, pieces of Foley catheter, and teflon beak of resectoscope sheath. The most common presenting symptoms were urinary frequency and dysuria. Endoscopic retrieval was possible in 8 (50.0%) patients, and the remaining underwent open cystostomy.

CONCLUSION

Intravesical foreign bodies should be included in the differential diagnosis of patients with chronic lower urinary tract problems. Radiological evaluation is necessary to determine the exact size, number, and nature of them. The most suitable method for removal of intravesical foreign bodies depends on the nature of the foreign body, age of the patient, and available expertise and equipment. Most intravesical foreign bodies can be retrieved with minimally invasive techniques.

摘要

引言

本研究的目的是评估在我院接受治疗的膀胱内异物患者的病因、诊断及处理方法,并回顾和更新当前文献中报道的膀胱内异物的处理。

材料与方法

在5年期间,巴基斯坦木尔坦尼什塔尔医学院医院有16例患者接受了膀胱内异物治疗。对这些患者的记录进行回顾性分析,以了解其病因、临床表现、诊断及处理情况。

结果

患者年龄在14至70岁之间,其中10例为男性。7例(43.8%)患者有医源性膀胱内异物,5例(31.3%)有来自邻近器官的迁移性异物,4例(25.0%)为自行将异物置入膀胱。异物包括铜丝、胡萝卜、铅笔、宫内节育器、手术纱布、导尿管碎片及电切镜鞘的聚四氟乙烯尖端。最常见的临床表现为尿频和尿痛。8例(50.0%)患者可行内镜取出,其余患者接受了开放性膀胱造瘘术。

结论

膀胱内异物应纳入慢性下尿路问题患者的鉴别诊断。进行影像学评估对于确定异物的确切大小、数量及性质很有必要。去除膀胱内异物最合适的方法取决于异物的性质、患者年龄以及现有的专业技术和设备。大多数膀胱内异物可通过微创技术取出。

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