Foreign bodies of the urethra
Last reviewed: 23.04.2024
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The famous English surgeon and urologist Henry Morris (1901) wrote: "Too long a sheet of foreign bodies could be made if we consider all those bodies that were introduced into the urethra insane, lascivious, curious and stupid."
Among these bodies can be noted hairpins, slips, fragments of sticks, seeds, feathers, pins, needles, etc. ".
ICD-10 code
T19. Foreign body in the genitourinary tract.
What causes foreign bodies of the urethra?
The main group of victims are young men. Often, foreign bodies are introduced by children during the game or for the purpose of masturbation. It is not possible to extract the foreign body back to the patient. Foreign bodies trapped in the urethra can move toward the bladder or remain in place of the initial implant.
Older people sometimes with a curative purpose injected into the urethra a candle consisting of various medications. Some of them are difficult to dissolve and become the basis for the formation of calculi. Sometimes parts of endoscopic instruments or cotton balls used for ureteroscopy turn out to be a foreign body.
Symptoms of foreign bodies of the urethra
Symptoms of foreign bodies of the urethra determine the shape, size and location of the foreign body. Most often, foreign bodies are located in the scaphoid fossa or bulbous section of the urethra. Very rarely they penetrate into the posterior part of the urethra.
Forcible introduction of foreign bodies into the urethra is accompanied by pain, which can dramatically increase during urination or erection, and subsequently, when the infection becomes infected, purulent and spotting appear due to permanent trauma to the mucous urethra.
The presence of a foreign body leads to edema mucosa, frequent and difficult urination. Sometimes acute urination retention develops. Large objects with sharp edges injure the wall of the urethra, causing urethrorrhagia. Small, smooth surfaces with little concern for patients. Foreign bodies, depending on the size and shape, partially or completely cover the lumen of the urethra.
Complications of foreign bodies of the urethra
The prolonged stay of a foreign body in the urethra leads to the development of bedsores, the spread of the inflammatory process to surrounding tissues and the occurrence of paraurethritis, the formation of urinary swells and the formation of the fistula of the urethra and its stricture.
Diagnosis of foreign bodies of the urethra
Detection of foreign bodies of the urethra is based on the collection of anamnesis (indication of the introduction of a foreign body), physical, x-ray and endoscopic methods of investigation.
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Instrumental diagnosis of foreign bodies of the urethra
The foreign body is found in the hanging part of the urethra or the corresponding crotch area with an external feeling, and in the membranous part during rectal examination. The position of the foreign body can be determined with the help of a metal bougie with its careful (not to push the foreign body into the bladder) into the urethra.
A major contribution to the diagnosis is made by the radiograph of the pelvis.
Urethroscopy and urethrography finally confirms the diagnosis and reveals the condition of the mucous membrane of the urethra.
What do need to examine?
What tests are needed?
Who to contact?
Treatment of foreign bodies of the urethra
To extract a foreign body most often succeeds without surgical intervention. Treatment of foreign bodies of the urethra depends on the localization, shape, volume and mobility of the foreign body. More dangerous is the presence of a foreign body in the prostatic part of the urethra, since the inflammation that has developed can spread to the prostate and bladder.
If the size and shape of the foreign body allows you to hope for its independent departure, patients are recommended to accumulate urine and, at the beginning of urination, shortly squeeze the outer orifice of the urethra with a strong stream of urine to get rid of it.
A smooth foreign body should be attempted to move towards the distal part of the urethra, for which it is fixed with the thumb and forefinger, first introducing into the lumen liquid petrolatum and gradually displacing to the outer opening. If necessary, perform meatotomy.
If these techniques do not help, they attempt to extract the foreign body with an instrument. Sometimes it is easier to move a foreign body into a soaked bubble, and then remove it by way of the suprapubic section.
Indications for hospitalization
Large fixed foreign bodies, as well as developed complications.
Fixed foreign bodies are easier to remove quickly, especially when they are in the hanging section of the urethra. It is more difficult to perform surgery in the posterior and especially membranous parts of the urethra. With limited inflammation with the outcome of abscessing, the abscess is opened. Remove the foreign body, the purulent focus drains. To discharge the urine, the suprapubic urinary fistula is superimposed.
Further management
It requires dynamic monitoring of patients with the purpose of prevention and timely treatment of urethral stricture.