An unusual urethral foreign body.
An unusual urethral foreign body.
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DOI：
10.1016/j.ijscr.2013.07.017
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发表时间：
2013
影响因子：
0.6
通讯作者：
Mulcahy, Maurice
中科院分区：
文献类型：
--
作者：
Naidu, Krishanth;Chung, Amanda;Mulcahy, Maurice
下尿路异物插入的发生率较低。插入各种物体的动机很难理解。鉴于阴茎尿道叉子的奇特性和不频繁性所面临的巨大管理挑战，该案例值得讨论。一名 70 岁的男子为了获得性满足而将叉子自我插入尿道后，出现尿道口出血，到急诊室就诊。考虑了多种检索方法，并通过镊子牵引和充分润滑取得了成功。尿道异物的表现可能有很大差异，插入物体的类型也有很大差异。自行插入尿道异物最普遍的动机是自体性欲。应根据可能存在的潜在心理或精神状况来探讨动机。最合适的手术拔牙技术可以通过体检和影像学来指导。内窥镜切除通常会成功，具体取决于物体的物理属性和形态。安排适当的随访很重要，因为可能会发生尿道狭窄等晚期并发症。心理和外科手术包括管理计划。异物取出取决于其物理属性和形态，目的是尽量减少尿路上皮损伤并保留勃起功能。从本质上讲，腔内泌尿外科拔牙是主要的取出手段。膀胱尿道镜检查对于诊断尿路上皮损伤并确保拔牙后完全清除异物很重要。
Lower urinary tract foreign body insertions have a low incidence. The motives for insertion of a variety of objects are difficult to comprehend. This case warrants discussion given the great management challenge faced by the oddity and infrequency with which a fork is encountered in the penile urethra. A 70-year-old man presents to the Emergency Department with a bleeding urethral meatus following self-insertion of a fork into the urethra to achieve sexual gratification. Multiple retrieval methods were contemplated with success achieved via forceps traction and copious lubrication. The presentation of urethral foreign bodies can vary widely, as can the type of object inserted. The most prevalent motivation for self-insertion of urethral foreign bodies is autoerotism. Motivations ought to be explored in light of possible underlying psychological or psychiatric conditions. The most appropriate surgical extraction technique can be guided by physical examination and imaging. Endoscopic removal is often successful, depending on the object's physical attributes and morphology. It is important to arrange appropriate follow-up, as late complications can occur such as urethral strictures. Psychological and surgical arms encompass the management plan. Foreign body retrieval is determined by its physical attributes and morphology with the aim to minimise urothelial trauma and preserve erectile function. Essentially, endourological extraction serves the primary means of retrieval. Cystourethoscopy is important to diagnose urothelial injuries and to ensure complete removal of foreign bodies following extraction.