Genitourethral foreign bodies: 20-year experience and outcomes from a single center.

Claris Oh, Darcy Noll, Athul John, Matthew Hong
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Abstract

Abstract: The presentation of a foreign body in the lower urinary tract is a challenging urological emergency with highly variable management approaches. A retrospective cohort study was undertaken to identify the patients who presented with self-inserted genitourethral foreign body to adult tertiary centers within our local health network (Southern Adelaide Local Health Network, Adelaide, Australia) from October 2002 to October 2022. Patient demographics, type of foreign body, psychiatric comorbidities, retrieval techniques, complications, and readmission data were extracted. Twenty-seven cases were identified with a median age of 44 years. Twenty-three (85.2%) were male and 4 (14.8%) were female. Ten patients (37.0%) had a concurrent psychiatric illness. The most commonly inserted foreign bodies were plastic tubes/wires (29.6%). Twenty cases (74.1%) were retrieved endoscopically. Three patients (11.1%) required open cystotomy and one underwent a transperineal urethrotomy. Four patients (14.8%) represented after discharge. Two patients had repeat presentations for genitourinary foreign body insertion. A significant monotonic positive trend of foreign body presentations was identified (Mann-Kendall tau = 0.95, P = 0.043). Presentations of genitourethral foreign body insertions have trended upward over the past two decades. However, most cases were successfully managed endoscopically.

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生殖泌尿道异物:一个中心 20 年的经验和结果。
摘要:下尿路异物是一种具有挑战性的泌尿科急症,其处理方法千差万别。我们开展了一项回顾性队列研究,以确定2002年10月至2022年10月期间在当地医疗网络(澳大利亚阿德莱德市南阿德莱德地方医疗网络)内的成人三级中心就诊的自插入生殖尿道异物患者。我们提取了患者的人口统计学特征、异物类型、精神疾病合并症、取物技术、并发症和再入院数据。共发现 27 例患者,中位年龄为 44 岁。男性 23 例(85.2%),女性 4 例(14.8%)。10名患者(37.0%)同时患有精神疾病。最常插入的异物是塑料管/线(29.6%)。20例患者(74.1%)通过内窥镜取出异物。三名患者(11.1%)需要进行开放性膀胱切开术,一名患者接受了经会阴尿道切开术。四名患者(14.8%)在出院后出现症状。两名患者因泌尿生殖系统异物插入而再次就诊。发现异物呈明显的单调正向趋势(Mann-Kendall tau = 0.95,P = 0.043)。过去二十年来,生殖泌尿道异物插入呈上升趋势。不过,大多数病例都能通过内窥镜成功处理。
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