Self-Inflicted Urethrovesical Foreign Bodies in Children

We present two cases of self-inflicted urethrovesical foreign body in children. Case 1 was a 6-year-old girl admitted with a history of self-introduction of a pin. The X-ray revealed the pin as 3.5？cm in length and in the bladder. The foreign body was removed endoscopically. Case 2 was a 13-year-old boy with a self-introduced packing needle, 13？cm in length, partially in the urethra. The end and the tip of the needle passed through the urethra to the surrounding tissues. Foreign body removed via a little skin incision with endoscopic guidance. Foreign bodies are rarely found in the lower urinary tract of children. Definitive treatment is usually the endoscopic removal; however, sometimes surgical intervention may require. 1. Introduction Self-introduction of the foreign body (FB) into the urethra and bladder in children has been rarely reported in the literature [1]. FBs were inserted or applied to the urethra for autoerotic, psychiatric, therapeutic purposes, or no definite reasons by the patient [2]. Majority of such cases are adult men. FBs are rarely found in the bladder of children. In this paper, we present two cases of self-inflicted foreign bodies through their urethra and review the literature. 2. Case 1 A 6-year-old girl was admitted to the emergency service with a history of self-introduction of a pin into her genital area approximately 3 hours after the event. The patient was asymptomatic, and the physical examination of the patient revealed normal findings with no sign of trauma at the external genitalia. Urinanalysis was normal. Posteroanterior and lateral pelvic radiogram showed a pin lies in the pelvis (Figure 1). Figure 1: Posteroanterior pelvic radiogram of case？？1. There is a linear, radio-opaque FB in the pelvis. Cystoscopy confirmed that a pin lies within the bladder. The pin has one sharp end and one plastic bead (Figure 2). The attempt of grasping to the pin with forceps in a suitable position for extraction was unsuccessful. Telescope was moved to backward, and the sharp end of the pin was taken into the cystoscope’s sheath (9？Fr). Then, the telescope was moved forward and the pin was caught between the sheath and the telescope. The pin was removed via transurethral route with cystoscope. The patient was discharged with psychiatric referral. Figure 2: The pin which was removed from bladder has one sharp end and one plastic bead. 3. Case 2 Thirteen-year-old boy was admitted to the pediatric surgery department with a history of self-insertion of a packing needle same day. It was associated with perineal pain and dysuria.