%0 Journal Article
%T Bedside Ultrasound in Workup of Self-Inserted Headset Cable into the Penile Urethra and Incidentally Discovered Intravesical Foreign Body
%A Ali Hajiran
%A Dana C. Point
%A Stanley Zaslau
%J Case Reports in Emergency Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/587018
%X There are multiple reports of foreign bodies inserted into the lower urinary tract. We report the case of an incidentally discovered foreign body identified within the bladder in a male patient presenting with a radio antenna protruding from the urethra attached to a head set. On workup patient was found to have an additional foreign body within the bladder and second radiolucent object within the urethra. This case demonstrates the importance of complete evaluation of the lower urinary tract during workup of inserted foreign bodies and the value of the bedside ultrasound as a diagnostic tool in distinguishing between rectal and genitourinary tract insertion. 1. Introduction Self-insertion of foreign objects in the lower genitourinary tract is a rare but well-documented occurrence in the urologic literature. There have been multiple cases of sharp objects (hair pins, tweezers, screws, nails, and fish hooks), large objects (AAA batteries, garden hoses, toothbrushes, and ballpoint pens), and organic materials (carrots, cucumbers, bamboo sticks, and leaves) discovered in the urethra and bladder of patients presenting to the emergency department [1¨C7]. While some patients may provide an accurate history and exhibit visible pathology on examination, many patients will present with nonspecific symptoms and provide poor histories due to either embarrassment or limited mental capacity [4, 8¨C10]. Subsequently, a high index of suspicion must be maintained in order to properly diagnose and manage patients with self-inserted foreign objects. We present a case of a developmentally delayed 64-year-old male with a month-long history of recurrent urinary tract infections. He presented to the emergency department with fishing line and a black electrical cable inserted into his penile urethra with an intact headset attached externally. Prompt bedside ultrasound revealed a second radioopaque object in the bladder. An anesthetic penile block was performed to facilitate removal of the fishing line and cable with gentle traction, followed by a bedside cystoscopy to retrieve a separate intravesicular coil of copper wire. All foreign bodies were safely removed without complications. The patient was subsequently discharged with a five-day course of prophylactic antibiotics. We suggest implementing bedside ultrasound as a quick, low-cost, and effective initial screening tool to evaluate all patients presenting with urethral foreign bodies to help rule out the possibility of additional objects in the urinary bladder. 2. Case Report A developmentally delayed 64-year-old gentleman
%U http://www.hindawi.com/journals/criem/2013/587018/