Unusual cause of urethral bleeding in an adolescent: a case in dilemma

2014 ◽  
Vol 26 (1) ◽  
pp. 149-151 ◽  
Author(s):  
Dig Vijay Singh ◽  
Arup Kumar Mandal
Keyword(s):  
Foreign Bodies ◽  
Ventral Surface ◽  
Adolescent Male ◽  
Urethral Injury ◽  
Psychiatric Evaluation ◽  
Ho:Yag Laser ◽  
Object A ◽  
Hemorrhagic Lesion ◽  
External Trauma ◽  
Urethral Lesion

Abstract Numerous cases of self-inflicted foreign bodies in the male urethra have been reported. A case of a self-inflicted urethral injury or hemangioma in an adolescent that presented a dilemma is described here. An adolescent male of 14 years presented with a complaint of intermittent urethral bleeding for a week. He attributed this to blunt trauma sustained while playing in school. On examination, there was no sign suggestive of any trauma or any abnormal lesion on the genitalia or surrounding area. On cystourethroscopy, there was a solitary hemorrhagic lesion of 0.5 cm with a bluish base on the ventral surface of the pendular urethra, 1 cm proximal to the fossa navicularis, which was ablated using Ho:YAG laser fiber (365 μm) through a working channel mounted in an OIU (optical internal urethrotomy) sheath. The absence of any sign of external trauma or presentation after 1 week of the incident suggests an element of falseness in the history. It may be due to embarrassment or fear, which contributes to self-insertion of foreign bodies into the urethra as the primary cause, especially in adolescent males. However, the trauma can be coincidental, with the bleeding of the urethra caused by a urethral lesion like a hemangioma and might present after a long gap of 1 week due to a lack of understanding or lack of severe symptoms. Most patients of self-inflicted injuries are too ashamed to admit that they inserted any object. A psychiatric evaluation is recommended for all these adolescents, with appropriate medical therapy when indicated.

Urethral injury due to external trauma

Urology ◽  
1978 ◽  
Vol 11 (6) ◽  
pp. 607-611 ◽  
Author(s):  
A.S. Cass ◽  
C.J. Godec
Keyword(s):  
Urethral Injury ◽  
External Trauma

scholarly journals An uncommon cause of soft tissue and knee infection after penetrating injury in a non-immunocompromised adolescent male

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110346
Author(s):  
Travis Bryant ◽  
Savannah Ellenwood ◽  
Olivia Butters ◽  
Frances M Saccoccio
Keyword(s):  
Vibrio Parahaemolyticus ◽  
Foreign Bodies ◽  
Oyster Shell ◽  
Adolescent Male ◽  
Open Wound ◽  
Shewanella Algae ◽  
Shewanella Species ◽  
Poor Outcomes ◽  
The Right ◽  
Shell Fragments

Non-cholerae Vibrio species and Shewanella species are organisms that rarely infect humans. Symptoms can range from gastroenteritis to wound infections to septicemia. In addition, these infections can lead to multiple poor outcomes ranging from amputations to death. We present a case of an 11-year-old male with prepatellar bursitis of the right knee due to Vibrio parahaemolyticus and Shewanella algae following an open wound in the Gulf of Mexico complicated by retained oyster shell fragments. He completely recovered after removal of the foreign bodies and organism-directed antimicrobial therapy with ciprofloxacin and doxycycline.

scholarly journals An Unusual Self-Inflicted Foreign Body in the Urinary Bladder and Urethra: A Case Report

2020 ◽  
Vol 18 (2) ◽  
pp. 94-97
Author(s):  
Mofizur Rahman ◽  
AKM Akramul Bari ◽  
Syeda Nafisa Khatoon
Keyword(s):  
Foreign Body ◽  
Minimally Invasive ◽  
Foreign Bodies ◽  
Plain Radiograph ◽  
Invasive Procedure ◽  
Clinical History ◽  
Urethral Injury ◽  
Case Presentation ◽  
Urethral Trauma ◽  
Urinary Tract Symptoms

Introduction: Most foreign bodies in the lower genitourinary tract are self-inserted via the urethra as the result of exotic impulses, psychometric problems, sexual curiosity, or sexual practice while intoxicated. Diagnosis of these foreign bodies can be done by clinical history, physical examination, and image studies of the patient. The treatment of foreign bodies is determined by their size, location, shape, and mobility. In most cases, minimally invasive procedures such as endoscopic removal are recommended to prevent bladder and urethral injuries. In some cases, however, surgical treatment should be done if the foreign bodies cannot be removed by the endoscopic procedure or further injuries are expected as a result of the endoscopic procedures. Case Presentation: Herein we present a case of self-inserted lower genitourinary foreign body. A 60 years old man presented with complaints of dysuria, dribbling, haematuria and suprapubic pain for 3 weeks. An X-ray of the pelvis showed a coiled up radio opaque shadow of telephone wire in the bladder region extending downwards which was removed by suprapubic cystostomy. Discussions: Bladder foreign body is not common. Plain radiograph is sufficient to diagnose and minimally invasive procedure is usually successful. In this case retrieval by cystostomy was done to avoid the risk of bladder and urethral injury. Conclusion: Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimize bladder and urethral trauma. The possibility of an intravesical foreign body should be considered in any patient with chronic unexplained lower urinary tract symptoms. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.94-97

scholarly journals Primary urethral reconstruction results in penile fracture

2018 ◽  
Vol 100 (1) ◽  
pp. 21-25 ◽  
Author(s):  
R Barros ◽  
MIS Silva ◽  
V Antonucci ◽  
L Schulze ◽  
L Koifman ◽  
...  
Keyword(s):  
Corpus Cavernosum ◽  
High Energy ◽  
Urethral Injury ◽  
Urethral Reconstruction ◽  
Urinary Flow ◽  
Penile Fracture ◽  
Urethral Stenosis ◽  
Absorbable Sutures ◽  
End To End ◽  
Urethral Lesion

Objective This study assessed primary urethral reconstruction results in patients with a penile fracture. Materials and methods Between January 2005 and April 2016, patients who underwent primary urethral reconstruction due to penile fracture were called for a follow-up. Epidemiological and clinical presentation data and operative findings were reviewed retrospectively. Partial urethral lesions were primarily treated with interrupted absorbable sutures over urethral catheter. In cases of complete urethral lesion, tension-free end-to-end anastomosis was performed. From the third month after surgery, all patients were interviewed using the International Prostate Symptom Score questionnaire and uroflowmetry. Retrograde urethrocystography was used in patients with urinary symptoms or altered uroflowmetry to rule out or confirm urethral stenosis. Results Of 175 patients with penile fractures, 27 (15.4%) had associated urethral injury. All patients were diagnosed with penile fracture by means of clinical history and physical examination. No subsequent examinations were conducted. Ages varied from 30 years to 58 years old (mean 39.2 years). All fractures resulted from sexual activity. Reported sexual positions were ‘doggy style’ position in eight cases (61.5%) and with the ‘man on top’ in five cases (38.4%). Ten patients (76.9%) experienced haematuria, ten (76.9%) had urethral bleeding and four (30.7%) suffered urinary retention. Unilateral and bilateral injury of the corpus cavernosum was observed in four (30.7%) and nine (69.2%) patients, respectively; partial injury was found in nine cases (69.3%) and complete urethral injury was noticed in four cases (30.7%). All cases of complete urethral injury were associated with bilateral lesion of the corpus cavernosum. Six patients who had uroflowmetry with maximum urinary flow rate below 15 ml/s and/or had IPSS above 7 underwent retrograde urethrocystogram, and this was normal in all cases, excluding the possibility of urethral stenosis. Two patients (15.3%) experienced surgical postoperative complications represented by an urethrocutaneous fistula and a subcutaneous abscess adjacent to the end-to-end anastomosis area. Conclusions Penile fracture is a rare urological emergency, especially when it is associated with a urethral lesion. This must be suspected when the clinical picture is suggestive or in cases of high-energy trauma, especially in bilateral lesions of the corpus cavernosum. Complementary imaging methods are not needed in these cases and immediate exploration should not be delayed. Primary urethroplasty produces satisfactory results with low complication levels. Nonetheless, prospective studies with larger samples should be conducted.

scholarly journals Needle as foreign body in urethra: Successful removal

2021 ◽  
Vol 7 (4) ◽  
pp. 212-214
Author(s):  
Vijay Kumar Kundal ◽  
Anil Kumar Garbhapu ◽  
Gali Divya ◽  
Sahil Mashal ◽  
Pinaki Ranjan Debnath
Keyword(s):  
Urinary Tract ◽  
Foreign Body ◽  
Lower Urinary Tract ◽  
Foreign Bodies ◽  
Feeding Tube ◽  
Psychiatric Evaluation ◽  
Adequate Information ◽  
Type Size ◽  
Successful Removal ◽  
Lower Urinary

: Self-inserted foreign bodies in the lower urinary tract are rare among children. The treatment of foreign bodies in the urethra is determined by their type, size, location, shape, and mobility. : We describe here a 10-year-old boy who had self inserted a needle into his urethra. Initial attempts to remove the needle from the urethra by inserting a cystoscope failed. The patient presented to our institution with bleeding per urethra with feeding tube insitu per urethra. As already attempted for urethroscopic removal, direct removal of needle done under general aneathesia done.: Per Rectal examination plays an important role and gives adequate information and timely management of the child leads to uneventful hospital stay Psychiatric evaluation is mandatory to detect an underlying mental disorder.

Reconstruction of Objects from their Projections Using Orthogonal Functions

1973 ◽  
Vol 31 ◽  
pp. 268-269
Author(s):  
Elrnar Zeitler
Keyword(s):  
Unit Area ◽  
Three Dimensional ◽  
One Dimension ◽  
Spatial Density ◽  
Dimensional Representation ◽  
Orthogonal Functions ◽  
Object A ◽  
Plane Normal ◽  
Dimensional Object ◽  
Spatial Density Distribution

Considering any finite three-dimensional object, a “projection” is here defined as a two-dimensional representation of the object's mass per unit area on a plane normal to a given projection axis, here taken as they-axis. Since the object can be seen as being built from parallel, thin slices, the relation between object structure and its projection can be reduced by one dimension. It is assumed that an electron microscope equipped with a tilting stage records the projectionWhere the object has a spatial density distribution p(r,ϕ) within a limiting radius taken to be unity, and the stage is tilted by an angle 9 with respect to the x-axis of the recording plane.

Scanning electron microscopy of the integument of schistosoma rodhaini

1986 ◽  
Vol 44 ◽  
pp. 132-133
Author(s):  
P. Evers ◽  
C. Schutte ◽  
C. D. Dettman
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Oral Sucker ◽  
Adult Male ◽  
Dorsal Surface ◽  
Ventral Surface ◽  
Sensory Receptors ◽  
East African ◽  
Dorsal Midline ◽  
Scanning Electron

S.rodhaini (Brumpt 1931) is a parasite of East African rodents which may possibly hybridize with the human schistosome S. mansoni. The adult male at maturity measures approximately 3mm long and possesses both oral and ventral suckers and a marked gynaecophoric canal. The oral sucker is surrounded by a ring of sensory receptors with a large number of inwardly-pointing spines set into deep sockets occupying the bulk of the ventral surface of the sucker. Numbers of scattered sensory receptors are found on both dorsal and ventral surfaces of the head (Fig. 1) together with two conspicuous rows of receptors situated symmetrically on each side of the midline. One row extends along the dorsal surface of the head midway between the dorsal midline and the lateral margin.

Foreign bodies in the pediatric patient

1998 ◽  
Vol 35 (4) ◽  
pp. 271-378 ◽  
Author(s):  
D JOHNSON ◽  
V CONDON
Keyword(s):  
Pediatric Patient ◽  
Foreign Bodies

A Large Bullet in the Bladder

Swiss Surgery ◽  
2001 ◽  
Vol 7 (3) ◽  
pp. 139-140 ◽  
Author(s):  
Halkic ◽  
Wisard ◽  
Abdelmoumene ◽  
Vuilleumier
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Gross Hematuria ◽  
Suprapubic Cystostomy ◽  
Laparoscopic Port ◽  
Urethral Trauma ◽  
Bullet Injury

All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimise bladder and urethral trauma. We report a case of a bullet injury to the bladder, which finally presented as a gross hematuria after remaining asymptomatic for four years. We present here an alternative to suprapubic cystostomy with a large bladder foreign body treated via a combined transurethral unroofing followed by removal using a grasper passed through a suprapubic laparoscopic port.

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