Department of Urology, London North West University Healthcare Trust, London, UK.
Department of Radiology, London North West University Healthcare Trust, London, UK.
Low Urin Tract Symptoms. 2023 Jan;15(1):31-34. doi: 10.1111/luts.12465. Epub 2022 Oct 18.
A 75-year-old man presented with mixed obstructive and storage lower urinary tract symptoms (LUTS). He had undergone transurethral resection of the prostate (TURP) 5 years and laparoscopic inguinal hernia repair 20 years ago. He had a stone adherent to the bladder wall and an occlusive prostate.
He underwent a re-do TURP and stone removal. Stone removal revealed an underlying metal coil straddling the bladder wall, which had served as a nidus for stone formation. The metal ring was a ProTack staple from previous hernia surgery, which had detached and wandered into the bladder. At follow-up after 12 weeks, the patient was asymptomatic, and his urine was sterile. Therefore, he chose to be treated conservatively for the ProTack and was started on periodic follow-up and cystoscopic surveillance. Shortly after review, he developed intestinal obstruction, which resolved spontaneously and was thought to be secondary to adhesions from other tacks that had migrated into the peritoneal cavity.
We have reported a case of a ProTack from a previous hernia repair migrating into the bladder and also causing intestinal obstruction. The case is very rare because of the combination of complications. Clinicians should beware of delayed complications and damage to other organs due to metallic hernia staples.
一名 75 岁男性因混合性梗阻性和储尿期下尿路症状（LUTS）就诊。他曾于 5 年前接受经尿道前列腺切除术（TURP），20 年前接受腹腔镜腹股沟疝修补术。他的膀胱壁上有一个结石，前列腺也有阻塞。
他接受了再次 TURP 和结石清除术。结石清除显示，一个横跨膀胱壁的金属线圈作为结石形成的核心，下面有一个隐藏的金属线圈。这个金属环是之前疝修补手术中的 ProTack 钉，已经脱落并游走进入膀胱。12 周后的随访时，患者无症状，尿液无菌。因此，他选择对 ProTack 进行保守治疗，并开始定期随访和膀胱镜检查。在复查后不久，他出现肠梗阻，自行缓解，认为是其他迁移到腹腔的钉导致的粘连所致。
我们报告了一例既往疝修补术 ProTack 迁移到膀胱并引起肠梗阻的病例。这种情况非常罕见，因为它同时存在多种并发症。临床医生应该注意金属疝钉引起的迟发性并发症和对其他器官的损害。
