Porav-Hodade Daniel, Gherasim Raul, Todea-Moga Ciprian, Reman Tibor, Feciche Bogdan Ovidiu, Hunor Kosza, Guliciuc Madalin, Orsolya Katalin Ilona Mártha, Coman Ioan, Crisan Nicolae
Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania.
Department of Urology, Clinical County Hospital Mures, 540136 Târgu Mures, Romania.
Diagnostics (Basel). 2024 Dec 15;14(24):2825. doi: 10.3390/diagnostics14242825.
BACKGROUND/OBJECTIVES: An electric wire inserted into the bladder or urethra presents a specific challenge that is frequently encountered in such cases: the potential formation of a tight knot, making extraction nearly impossible. The primary objective of this study was to share our personal experience with patients who had intravesical electric cable insertions and to provide an extensive literature review, offering detailed insights into the various strategies reported for managing such foreign body cases.
Of the four cases with a foreign body in the lower urinary tract, two involved patients aged 19 and 53, respectively, who had inserted an electric cable. During their attempt at self-removal, they developed an intravesical knot, as confirmed by radiographic imaging.
In the first case, a bipolar approach was used: a cystoscope was inserted transurethrally into the bladder alongside the cable, while a laparoscopic trocar was introduced suprapubically. Using laparoscopic scissors, the cable was successfully cut and removed. In the second case, due to the cable's size, a direct cystotomy was performed. At the 3-month follow-up, the uroflowmetry results were normal for both patients. A psychiatric evaluation revealed no abnormalities in the first patient, while the second patient was diagnosed with polyembolokoilamania.
The removal of self-inserted electric cables from the urethra and bladder is a challenging procedure, often requiring the urologist's creativity to prevent potential complications. Many cases can be resolved endoscopically; however, even this minimally invasive approach must be tailored to each case to provide the most suitable solution for the patient.
背景/目的：将电线插入膀胱或尿道会带来一种在这类病例中经常遇到的特殊挑战：可能形成紧密的结，导致几乎无法取出。本研究的主要目的是分享我们在膀胱内插入电缆患者方面的个人经验，并提供广泛的文献综述，深入详细地介绍报道的处理此类异物病例的各种策略。
在下尿路有异物的4例病例中，2例分别为19岁和53岁的患者插入了电缆。在他们尝试自行取出时，经影像学检查证实形成了膀胱内结。
第一例采用双极方法：通过尿道将膀胱镜经尿道插入膀胱，与电缆并行，同时经耻骨上引入腹腔镜套管针。使用腹腔镜剪刀成功切断并取出电缆。第二例由于电缆尺寸原因，进行了直接膀胱切开术。在3个月的随访中，两名患者的尿流率结果均正常。精神科评估显示第一例患者无异常，而第二例患者被诊断为多栓塞性脂肪瘤病。
从尿道和膀胱中取出自行插入的电缆是一项具有挑战性的操作，通常需要泌尿外科医生发挥创造力以预防潜在并发症。许多病例可通过内镜解决；然而，即使是这种微创方法也必须根据每个病例进行调整，为患者提供最合适的解决方案。
