Medical Foreign Bodies in Urinary Bladder： a Case Report

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Chin Med Sci JSeptember 201 3CASE REPoI TCHINESEMEDICAL SCIENCESJOURNALVo1．28， No．3P．192—193Medical Foreign Bodies in Urinary Bladder：a Case ReportHal Wang’
，
Zhi—gang Ji似
，
He Xiao’
，
and Ji．rui Niu2’Department of Urology
， Peking Union Medical Colege Hospital，Chinese Academy ofMedical Sciences＆Peking Union Medical Colege，Beijing 1 00730，ChinaDepartment of Urology，Heilongjiang Province Hospital，Harbin 1 50036，ChinaKey words：urinary tract foreign body；iatrogenicityChin Med Sci J 2013；28(3)：192—193ETAINED foreign bodies in the urinary tractafter surgical or diagnostic procedure，namediatrogenic foreign bodies，are rarely reported，though the estimated incidence was as high as1／1500 cases． Prompt and proper retrieval is required dueto potential complications．We report a case of iatrogenicforeign body into the bladder.

CASE DESCRIPTIONA 60一year-old man had recurrent hematuria for 9months and vesicuIar mass for 1 month．He received asuprapubic transvesical prostatectomy 9 months ago，butgross hematuria had appeared since then． Hematuriareduced to microscopic leveI but COUId not ceasecompletely．Cystoscopy report in another hospital wasnOrma1． One month ago， ultrasOn0graphy in anotherhospital reported a hyperechoic mass．1．8 cmx2．8 cm insize， Jocated j几 the jnner wal J of urinary bladder，accompanied with immobile acoustic shadowing．Therewas no fever，pain，Or micturition disorders.

On physical examination，the patient was generaly wel1.

Chest and abdominal examinations were unremarkable．UrineReceived for publication January 28，201 3Corresponding author Tel：86-1 0-691 56031，E-mail：jzgl 1 29###medmaiI．com．cnexamination showed pus cels 125 cels／pL，positive nitrateand trace red cels．CT(Fig．1)of the pelvis showed anon—enhancing hyper dense mass，located on the anteriorwaII and at the right side of the bladder neck.

On cystoscopy，a reticular foreign body(Fig．2)，about2 cm ×2 cm in size and covered by calcium crystaIs wasseen to the right side of the anterior vesicular waI．whichwas successfuIly removed after fragmentation．Pathologicexamination demonstrated sutures， mixed with somefjbrOvascu Jar tissues and chronic jnflammation”.

His urine analysis returned to n0rmal durina folow．uP.

Repeat cystoscopy showed intact mucosa with mild scarformation in the place where the mass formerIv located．Onfurther questioning，the patient admitted having receivedblood transfusion of about 3000 mL durina the previousprostatectomy.

DISCUSSIONU rinary tract can be site of various foreign bodies．suchas copper wire， lead pencil， hair pin， intrauterine device， ，surgical gauze， 一 pieces of Foley catheter， 一 and blades.

Iatrogenic procedures were the leading source of foreignbodies．ranging fr0m 43．8％ to 80．0％ ．Other introductionroutes include accidentaI or deliberate self-insertion．physicaItorture and migration from adjacent organs． The mostcommon clinicaI presentation is dysuria and hematuria：other