UNAIR NEWS – The case of a foreign object in the urinary tract is interesting if examined from a medical perspective. Given these organs are located in locations that are difficult to reach directly. Namely, the pelvis is in front of the rectum and is protected by the surrounding body parts.
The bladder functions as a temporary storage area for urine before it is finally released periodically from the kidney. Furthermore, there is a urethra that connects the bladder to the outside environment. Male’s urethra is longer than a woman’s and empties into the same canal as the reproductive tract.
In several cases, a foreign object found in the bladder is caused by insertion of the object into the urethra and bladder for sexual satisfaction. This disorder is often associated with mental and psychological disorders. As experienced by one patient in the Department of Emergency Hospital Dr. Soetomo.
According to Dean of Faculty of Medicine (FK) Universittas Airlangga who is also an expert in the field of urology, Prof. Dr. Soetojo, Dr., Sp.U. (K), the patient came with complaints that the headset is stuck in the penis to the bladder so it cannot be pulled out. The condition results in pain accompanied by a discharge of blood in the urethra.
“Initially, the patient came in stable condition. After a general check, both blood and hemodynamics are within normal limits. When physical examination also found no injuries. His condition is suspected as a mental disorder. However, patients refute a history of mental disorders or a history of related therapy before, “said Prof. Soetojo.
When conducting laboratory tests, continued Prof. Soetojo, found an increase in leukocytes which means the headset in the bladder of the patient has a high risk of infection. In response, the team of doctors immediately took further actions such as radiological examination and uretrography to find out the position of the headset and urinary tract conditions.
“As a result, a plain abdominal radiograph shows a tube-shaped metal opacity that forms the letter T in the pelvic cavity. The doctor then decides to carry out vesicotomy surgical intervention. After surgery, monitoring is still carried out by observing complaints, vital signs, urine production, as well as patient catheter drainage, “he said.
The UNAIR professor emphasized that the case of foreign bodies in the bladder was classified as an emergency. In simple cases, an endoscopic approach is needed to extract objects through a cytoscopic procedure that uses a biopsy forcep. However, if the object is large, then the surgical procedure needs to be considered.
“Because the entry of foreign objects into the body can cause various kinds of complications, such as calculus formation and infection. Although not threatening, this case will be dangerous if it causes damage to blood vessels or invasion of foreign objects into the peritoneal area, “said Head of Department / SMF Urology 2011-2015.
He also advised that in medical cases, the discovery of foreign bodies in the reproductive organs and urinary tract must be suspected as a result of sexual harassment or mental disorders. In addition to medical and surgical approaches to extracting foreign bodies, the mental condition of the patient also needs to be followed up through treatment in psychiatry. (*)
Author: Nabila Amelia
Editor: Khefti Al Mawalia
Soetojo and Hasan Madani (2019). Case Report: A Headset in the Bladder. Folia Medica
Indonesiana, 55(2):153-158. http://dx.doi.org/10.20473/fmi.v55i2.14393