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      Open surgery for urethral foreign body Translated title: Tratamiento quirúrgico convencional de cuerpo extraño uretral

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          Abstract

          Abstract The introduction of foreign bodies in the urethra are uncommon. Given its rarity, the approach to this condition is not standardized but it is highlighted that minimally invasive procedures should be prioritized depending on its feasibility. In the present study, we report a case of a 60-year-old male patient with bipolar disorder and a foreign body impacted in the bulbar urethra with open surgical resolution after a failed endoscopic treatment. We perform an analysis into the diagnostic and therapeutic methods used, with postopera tive results.

          Translated abstract

          Resumen La introducción de cuerpos extraños uretrales es poco frecuente, razón por la cual, la mayoría de las publicaciones disponibles en la literatura son reportes de casos aislados o pequeñas series con gran heteroge neidad. Existen distintas aproximaciones frente a esta afección, desde métodos menos invasivos hasta cirugías abiertas más complejas. Presentamos un caso de cuerpo extraño impactado en uretra bulbar con el objetivo de analizar métodos diagnósticos empleados y aproximaciones terapéuticas concluyendo en la resolución quirúrgica convencional. Se evaluaron resultados postoperatorios.

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          Self-inflicted male urethral foreign body insertion: endoscopic management and complications.

          To evaluate the cause, diagnosis, management and complications of self-inserted urethral foreign bodies in men, reviewing a 17-year experience. From November 1986 to January 2004, 17 men were treated for self-inflicted urethral foreign bodies; the records were analysed retrospectively for presentation, diagnosis, management and complications. In all 17 patients the foreign bodies were clearly palpable. Objects included speaker wire, an AAA battery, open safety pins, a plastic cup, straws, a marble, and a cotton-tipped swab. The most common symptom was frequency with dysuria, but there was sometimes gross haematuria and urinary retention. The cause for inserting the foreign body varied; psychiatric disorder was the most common, followed by intoxication, and erotic stimulation was the cause in only five patients. All patients had diagnostic imaging; plain pelvic images were sufficient in 14, ultrasonography or computed tomography was needed in three. Endoscopic retrieval was successful in all but one patient, where a perineal urethrotomy was required. The most common complications were mucosal tears and false passages. Urethral strictures were associated with multiple attempts to insert the foreign body. Self-inflicted urethral foreign-body insertion in men is unusual. A radiological evaluation is necessary to determine the exact size, location and number of foreign bodies. Endoscopic retrieval is usually successful, and antibiotic coverage is necessary. A psychiatric evaluation is recommended for all patients, with appropriate medical therapy when indicated. Late manifestation has included urethral stricture disease, and a close follow-up, albeit difficult in these patients, is desirable.
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            Urethral Foreign Bodies: Clinical Presentation and Management

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              An unusual urethral foreign body☆

              INTRODUCTION Lower urinary tract foreign body insertions have a low incidence. The motives for insertion of a variety of objects are difficult to comprehend. This case warrants discussion given the great management challenge faced by the oddity and infrequency with which a fork is encountered in the penile urethra. PRESENTATION OF CASE A 70-year-old man presents to the Emergency Department with a bleeding urethral meatus following self-insertion of a fork into the urethra to achieve sexual gratification. Multiple retrieval methods were contemplated with success achieved via forceps traction and copious lubrication. DISCUSSION The presentation of urethral foreign bodies can vary widely, as can the type of object inserted. The most prevalent motivation for self-insertion of urethral foreign bodies is autoerotism. Motivations ought to be explored in light of possible underlying psychological or psychiatric conditions. The most appropriate surgical extraction technique can be guided by physical examination and imaging. Endoscopic removal is often successful, depending on the object's physical attributes and morphology. It is important to arrange appropriate follow-up, as late complications can occur such as urethral strictures. CONCLUSION Psychological and surgical arms encompass the management plan. Foreign body retrieval is determined by its physical attributes and morphology with the aim to minimise urothelial trauma and preserve erectile function. Essentially, endourological extraction serves the primary means of retrieval. Cystourethoscopy is important to diagnose urothelial injuries and to ensure complete removal of foreign bodies following extraction.
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                Author and article information

                Journal
                medba
                Medicina (Buenos Aires)
                Medicina (B. Aires)
                Fundación Revista Medicina (Ciudad Autónoma de Buenos Aires, , Argentina )
                0025-7680
                1669-9106
                October 2022
                : 82
                : 5
                : 791-793
                Affiliations
                [1] orgnameHospital Alemán de Buenos Aires orgdiv1Departamento de Urología Argentina
                Article
                S0025-76802022000900791 S0025-7680(22)08200500791
                36220042
                94d5c9be-1b7d-4ac2-a725-7c637707efaa

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 30 March 2022
                : 21 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 3
                Product

                SciELO Argentina

                Categories
                Case Reports

                Cystoscopy,Urethral foreign body,Urethroplasty,Cuerpo extraño uretral,Desorden psiquiátrico,Citoscopía,Psychiatric disorder,Uretroplastía

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