DIAGNOSIS AND TREATMENT OF URETHRAL AND URINARY FOREIGN BODIES IN ADULTS

Aim. To improve the quality of diagnosis and treatment of urethral and urinary foreign bodies (FB). Materials and methods. Thirty eight cases of urethral and urinary foreign bodies observed at CCUH № 47 and CCH № 57 of Moscow over the period from 1995 to 2015 were analyzed retrospectively. To diagnose FB, clinicolaboratory, roentgenological, ultrasound and endoscopic methods for investigation of urogenital organs were used. Results. The incidence rate of urethral and urinary FB was approximately 1 case per each 3500-4000 cases of acute urogenital diseases a year. More than 2/3 of patients were young men, half of them suffered from different mental diseases. In more than 1/2 of cases, different FB, predominantly household goods, were inserted into the urethra for autoerotic purpose. In 2/3 of cases foreign bodies provoked an acute ischuria and macrohematuria requiring urgent hospitalization. All patients were divided into 2 clinical groups different by age, structure of concomitant diseases, causative factors, localization and character of FB. Diagnosis of FB was carried out by the algorithm, developed by us, which included sequential use of clinicoradial, instrumental and endoscopic methods of study. Urethrocystoscopy used for diagnosis and withdrawal of FB from the urethra and urinary bladder was preferable. Conclusions. Division of patients with urethral and urinary FB into clinical groups into clinical groups contributed to optimization of diagnostic process, and in some cases helped to determine medical tactics. Clinicoradial and instrumental methods helped to diagnose, to assess sizes, localization of FB and to determine medical tactics in 85 % of patients. Surgical urethrocystoscopy, as the basic technique, permitted to withdraw urethral and urinary FB from 80 % of patients.

Urethral and urinary foreign bodies, diagnosis and treatment