Bir Garip Kaza: Posterior Üretrasında İğne Olan Bir Çocuk

Year 2020, Volume: 2 Issue: 3, 178 - 180, 01.11.2020

Yonca Senem Akdeniz , Musa Balta , Afşın İpekci , İbrahim İkizceli

https://doi.org/10.38175/phnx.795036

Abstract

Amaç: Penis içine yabancı cisim yerleştirilmesi tüm dünyada görülen bir fenomendir. Literatürde sayılı vaka bildirimleri vardır ancak Türkiye’ de bildirilen vakalar göreceli olarak çok azdır ve çoğunlukla yetişkindirler.
Olgu: Acil servise 11 yaşında erkek hasta üretra dış ucunu kaşırken iğnenin yanlışlıkla kayıp üretra içine girmesi şikayeti ile başvurdu. Düz pelvis grafisinde posterior üretra seviyesinde iğne görüldü. Sistoskopi ile iğne bulbar üretradan çıkarıldı.
Sonuç: Kendi üretrasına yabancı cisim yerleştirme vakaları nadir değildir. Hastalar çoğunlukla dizüri, piyüri, sık idrara çıkma,hematüri, idrar retansiyonu, penis veya perineal bölgede şişme şikayeti ile başvururlar. Tanı için düz pelvis grafisi çoğunlukla yeterlidir, ultrasonografi ve bilgisayarlı tomografi diğer seçeneklerdir. Tedavide endoskopik olarak çıkarma ilk seçenektir ve çoğu vakada başarılı sonuç alınır ancak nadiren açık cerrahi işlem gerekebilir.

Keywords

üretra, yabancı cisim, acil servis

A Bizarre Accident: A Boy with a Needle in the Posterior Urethra

Abstract

Objectives: Self-insertion of penile foreign bodies is a common phenomenon worldwide. In the literature, there are numerous reported cases of self-inflicted foreign objects in the urethra but in Turkey, the reported cases are relatively few and these are usually adult cases.
Case: An 11 years-old male presented to the emergency department with inadvertently slipping a needle in his urethra after itching the urethral orifice with the needle. A plain x-ray of the pelvis showed a needle approximately about the level of the posterior urethra. By cystoscopy, the needle is completely removed from the bulbar urethra without any complication.
Conclusion: Cases of self-inserted urethral bodies are not rare. Patients often present with voiding symptoms such as dysuria, pyuria, increased urinary frequency, hematuria, urinary retention, and penile or perineal swelling. Pelvic x-ray is usually sufficient for diagnosis; ultrasonography and computerized tomography are the next choices. Endoscopic retrieval is the initial management and, in most cases, it is successful; open surgery is rarely required.

Keywords

foreign body, emergency room, Urethra

References

• Rodríguez D, Thirumavalavan N, Pan S, Apoj M, Butaney M, Gross MS, Munarriz R. Epidemiology of genitourinary foreign bodies in the united states emergency room setting and its association with mental health disorders. Int J Impot Res. 2020; 32:426-433.
• Rahman NU, Elliott SP and Mcaninch JW. Self-inflicted male urethral foreign body insertion: endoscopic management and complications. BJU International. 2004;94:1052-1053.
• He Y, Zhang W, Sun N, Feng G, Ni X, Song H. Experience of pediatric urogenital tract inserted objects: 10-year single-center study. J Pediatr Urol. 2019;15(5):554.e1-554.e8.
• Mahadevappa N, Kochhar G, Vilvapathy KS, Dharwadkar S, Kumar S. Self-inflicted foreign bodies in lower genitourinary tract in males: Our experience and review of literature. Urol Ann 2016;8:338-42.
• Gunasekaran K, MurthiIn S. Unusual metallic penile foreign body. BMJ Case Rep 2017;1-2
• Pehlivanov G, Kavaklieva S, Kazandjieva J, Kapnilov D, Tsankov N. JEADV. Foreign-body granuloma of the penis in sexually active individuals (penile paraffinoma). 2008;22:845–851.
• Zaghbib S, Ouanes Y, Chaker K, Ben Chehida MA, Daly KM, Nouira Y. Urethral self-inserted sewing needle in a 14-year-old boy for autoerotic stimulation. Urology Case Reports. 2019;25:1-3
• Cam B, Tuncer H, Uzun O, Uysal E. Nail scissor as a rare foreign body in the urethra: Case report. Cureus 11(1): e3851.
• Kinjo T1, Oka T1, Imanaka T1, Yamanaka Y1, Nomura H1, Yoshioka I1, Takada S. Urethrocutaneous fistula caused by a vesical foreign body in an adolescent boy: a case report. Acta Urol Jap. 2019;65(8):341-345.
• Hwang EC, Kim JS, Jung SI, Im CM, Yun BH, Kwon DD, et al. Delayed Diagnosis of an Intraurethral Foreign Body Causing Urosepsis and Penile Necrosis. Jun Eul Hwang. Korean J Urol. 2010;51:149-151.
• Elawdy M, El-Halwagy S, Mousa EE, and Maliakal J. Self-insertion of an odd ureth ral foreign body that led to Fournier's gangrene. Urol Ann. 2019;11(3):320–323.
• Ahsaini M, Bounoual M, Mellas S, El Ammari J, Tazi MP, El Fassi MJ, Farih MH. Corps étranger intra urétral inhabituel chez un adolescent schizophrène: à propos d’un cas. Pan African Medical Journal. 2018;31:217.