Simple foreign bodies
The first category includes objects that can be grabbed with forceps or a basket and freely removed through the urethra without damaging the mucous membrane: soft fragments of tubes, threads, small smooth objects without inlay. The procedure is performed using videocystoscopy under local anesthesia with gel or light sedation; in men with long objects - under spinal anesthesia. After removal, the bladder is examined for injuries, a short course of antibiotic is prescribed, and the patient goes home the same day.
Where do foreign bodies in the urinary tract come from?
Most often these are fragments of medical devices: fragments of catheters, stents, nephrostomies, ligatures and meshes after operations, migrated intrauterine devices; less often - objects inserted into the urethra by the patient himself, and fragments after injuries. A foreign body causes pain, blood in the urine, infection, and over time it becomes covered with salts and turns into stone, so it must be removed as soon as possible.
How to remove
Most foreign bodies are removed endoscopically: through a cystoscope, the object is grabbed with forceps, a basket or a loop and removed through the urethra; long and flexible objects are turned along their axis, inlaid objects are first freed from salts with a laser. Foreign bodies of the ureter are removed using a ureteroscope followed by stenting. For large, sharp or fixed objects where endoscopic removal risks damaging the urethra, a suprapubic approach is used. Antibiotic prophylaxis is mandatory.
