Bansal Ankur, Yadav Priyank, Kumar Manoj, Sankhwar Satyanarayan, Purkait Bimalesh, Jhanwar Ankur, Singh Siddharth
Department of Urology, King George Medical University, Lucknow, India.
Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Int Neurourol J. 2016 Sep;20(3):260-269. doi: 10.5213/inj.1632524.262. Epub 2016 Sep 23.
This study was performed to characterise the nature, clinical presentation, mode of insertion, and management of intravesical foreign bodies in patients treated at our hospital.
Between January 2008 and December 2014, 49 patients were treated for intravesical foreign bodies at King George Medical University, Lucknow. All records of these patients were retrospectively analysed to characterise the nature of the foreign body, each patient's clinical presentation, the mode of insertion, and how the case was managed.
A total of 49 foreign bodies were retrieved from patients' urinary bladders during the study period. The patients ranged in age from 11 to 68 years. Thirty-three patients presented with complaints of haematuria (67.3%), 29 complained of frequency of urination and dysuria (59.1%), and 5 patients reported pelvic pain (10.2%). The circumstances of insertion were iatrogenic in 20 cases (40.8%), self-insertion in 17 cases (34.6%), sexual abuse in 4 cases (8.1%), migration from another organ in 4 cases (8.1%), and assault in 4 cases (8.1%). Of the foreign bodies, 33 (67.3%) were retrieved by cystoscopy, while transurethral cystolitholapaxy was required in 10 patients (20.4%), percutaneous suprapubic cystolitholapaxy was performed in 4 patients (8.1%), and holmium laser lithotripsy was performed in 2 patients (4.08%).
Foreign bodies should always be included in the differential diagnosis when evaluating a patient who presents with chronic lower urinary tract symptoms. A large percentage of foreign bodies can be retrieved using endoscopic techniques. Open surgical removal may be performed in cases where endoscopic techniques are unsuitable or have failed.
本研究旨在对我院收治的膀胱内异物患者的异物性质、临床表现、置入方式及处理方法进行特征描述。
2008年1月至2014年12月期间,勒克瑙乔治国王医科大学对49例膀胱内异物患者进行了治疗。对这些患者的所有记录进行回顾性分析,以明确异物性质、每位患者的临床表现、置入方式以及病例的处理情况。
在研究期间,共从患者膀胱中取出49个异物。患者年龄在11岁至68岁之间。33例患者出现血尿症状(67.3%),29例患者有尿频和尿痛症状(59.1%),5例患者报告有盆腔疼痛(10.2%)。置入情况为医源性20例(40.8%),自行置入17例(34.6%),性虐待4例(8.1%),从其他器官迁移4例(8.1%),袭击4例(8.1%)。其中33个异物(67.3%)通过膀胱镜取出,10例患者(20.4%)需要行经尿道膀胱结石碎石术,4例患者(8.1%)进行了经皮耻骨上膀胱结石碎石术,2例患者(4.08%)进行了钬激光碎石术。
在评估出现慢性下尿路症状的患者时,应始终将异物纳入鉴别诊断。大部分异物可通过内镜技术取出。在内镜技术不适用或失败的情况下,可进行开放手术取出。