Foreign bodies in the female urinary bladder: 20-year experience in Ramathibodi Hospital

OBJECTIVE: Foreign bodies in the female urinary bladder may occur by self-insertion or migration from adjacent organs. The most common reason for this is sexual in nature, but hygienic behaviour and attempts to relieve voiding problems have been reported. Only small case series were found in the literature devoted to foreign bodies in the urinary bladder. Therefore, we reviewed our experience regarding foreign bodies in the female urinary bladder in our hospital. METHODS: Medical records of female patients who were diagnosed with a foreign body in the urinary bladder during 1985-2005 were reviewed. Demographics, causes, type of object found, clinical presentation, treatment and outcomes were noted. RESULTS: Seventy-eight patients with a mean age of 38 years were identified. The major route for ingress of foreign bodies was via the urethra. The objects found self-inserted were cotton swabs, tampons, paper clips and pen casings. As most of Thailand is an agricultural environment, some small living organisms such as leeches could be found as foreign bodies in the bladder. The majority of the cases presented with haematuria associated with frequency, urgency and pelvic pain. Almost all cases could be managed by endoscopic removal with minimal complications. Four cases were treated by open surgery. CONCLUSION: Foreign bodies in the urinary bladder represent a urological challenge that requires prompt management. The suspected history and presenting symptoms are crucial and lead to further investigations. Gentle endoscopic management is the main treatment with a high success rate.