A Very Long Foreign Body in the Bladder

Atsushi Imai, ¹ Yuichiro Suzuki, ¹ Yasuhiro Hashimoto, ^{1 ,*} Atsushi Sasaki, ¹ Hisao Saitoh, ¹ and Chikara Ohyama ²

2. Case Summary

The patient was a 49-year-old male with no history of any psychiatric disorder. Gross hematuria was noted. He underwent medical examination at the local emergency room and was referred to us for examination of a foreign body in the bladder, which had been identified by ultrasonography. On physical examination, the patient did not report any abdominal pain. A plain X-ray revealed a convoluted foreign body measuring approximately 5 cm in diameter as well as a thickening in the bladder wall (Figure 1). Cystoscopy indicated a stone-like nature of the foreign body. According to the patient, approximately two years ago, he had inserted a vinyl tube into his urethra for masturbation and was unable to retrieve it; it had remained in this position, because of which he experienced urethral pain for the first six months after the incident. Because the foreign body was large, surgery by the transurethral approach was considered difficult. Therefore, suprapubic approach was performed under general anesthesia, and almost the entire foreign body mass was excised in a single lump (Figure 2). The stone-like foreign body (vinyl tube) was approximately 140 cm in length and was considered to have been intravesically curled into a spiral (Figure 3). The patient’s postoperative course was uneventful.