Complex foreign bodies
Objects that remain in the bladder for a long time become overgrown with salts and are fixed to the mucous membrane, sharp objects (needles, wire) risk damaging the wall when removed, and large ones do not pass through the urethra. In such cases, under anesthesia through a resectoscope, the inlays are destroyed with a laser, if necessary, the object is cut into pieces and fragments are removed; if this is not possible, a small suprapubic incision is made to open the bladder. Be sure to inspect the bladder wall: if it is damaged, leave a catheter in place for 5–7 days. The migrated intrauterine device is removed together with the gynecologist.
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.
