Fragmentation and transurethral removal in saline of an intravesical foreign body: A case report
The Department of Urology, The Fraternity Memorial Hospital.Hinyokika kiyo. Acta urologica Japonica 09/2010; 56(9):509-12.
A 28-year-old male visited our hospital with complaint of lower abdominal pain, hematuria and urinary urgency. He had inserted a fishing line into the bladder transurethrally for sexual masturbation. The fishing line was made of nylon and was 1.66 mm in diameter. He could not remove it by himself due to pain. Retraction of the line with forceps was impossible ; the intricately entangled line was blocked at the bladder neck. We fragmented the line by a transurethral resection system operated in saline (TURis) and removed it transurethrally. The total length of the fishing line in the bladder reached 464 cm. TURis was useful for fragmentation of this foreign object, which consisted of electro-resistant material and could not be cut by conventional TUR.
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ABSTRACT: Leiomyoma of prostate are rare benign neoplasms that are usually diagnosed incidentally through postoperative pathological examination. A 70-year-old man is presented with severe symptoms of lower urinary tract obstruction. Although a digital rectal examination and the prostate-specific antigen level did not suggest malignancy, transrectal ultrasonography showed an unusual homogenous echoic mass measuring 45×37 mm in size in the prostate. A needle biopsy was performed and pathological diagnosis was prostatic leiomyoma. Holmium laser enucleation of prostate (HoLEP) was chosen and performed to resect the tumour. Although the enucleation step presented no problems, the morcellation procedure using a conventional transurethral mechanical morcellator was very difficult owing to the firmness of the tissue. By using a bipolar erectrosurgical loop, fragmentation and removal of tissue was accomplished. This is the first case reported of these rare neoplasms in which HoLEP was offered as a less invasive surgical approach. We emphasise the firmness of the leiomyomatous tissue, which would lead to morcellation failure.
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