Foreign Bodies in the Urinary Bladder: 10 Year Experience in Al-Ramadi Teaching Hospital


ABSTRACT:BACKGROUND: A wide range of objects have been inserted into the urinary bladder posing a challenge to urologists for diagnosis and management. Although it is not a fatal disease but can lead to serious complications. OBJECTIVE:To study the presentation, causes, diagnosis and treatment of urinary bladder foreign bodies.PATIENTS AND METHODS: From May 2001 to December 2011, 21 patients had been treated for intravesical foreign bodies at Al Ramadi teaching hospital , Anbar governorate / west of Iraq. All of the patients had underwent ultrasonography of the urinary tract , plain abdominal radiography and cystoscopy. The patient’s records were reviewed retrospectively and their clinical data were analyzed. RESULTS:A total of 21 patients with mean age of 39.2 years with male: female ratio (1:2.5). The most common presentation was recurrent urinary tract infection. Frequency, dysuria, Hematuria, difficulty with micturition, and urinary retention were the other complaints at presentation. The most common cause is iatrogenic (42.9%) followed by self insertion (33.3%), migration from outside the bladder (14.3%) and external trauma (9.5%). Definitive diagnosis of vesical foreign body was achieved by ultrasonography only in (9.5%), by plain abdominal radiography only in (28.6%),by both in (14.3%) of patients and cystoscopy was needed to establish the diagnosis in (47.6%), of them 5 cases had been erroneously reported to be bladder calculi. Intravesical foreign bodies had been removed endoscopically in 19 (90.5%) patients, and in the remaining 2 (9.5%), by open surgery. No significant complications were recorded postoperatively.CONCLUSION: Urinary bladder foreign bodies are not uncommon and should be suspected in patients presenting with chronic lower urinary tract complains. The incidence of iatrogenic foreign bodies in the urinary bladder is increasing. Radiological evaluation and cystoscopy are necessary to confirm the presence of foreign bodies and to determine the size, number, and nature of foreign bodies. Most urinary bladder foreign bodies can be removed by endoscopic and minimally invasive techniques without the need for open surgery