Investig Clin Urol.  2016 Nov;57(6):449-452. 10.4111/icu.2016.57.6.449.

Removal of foreign bodies embedded in the urinary bladder wall by a combination of laparoscopy and carbon dioxide cystoscopic assistance: Case report and literature review

• Jin C
• Fan Y
• Zhang Q
• Wang Y
• Wu S
• Jin J

• KMID: 2451405
• DOI: http://doi.org/10.4111/icu.2016.57.6.449

Abstract

PURPOSE
To report a case of combined laparoscopic and carbon dioxide partial cystectomy and foreign body removal and to review the existing literature on the topic.
MATERIALS AND METHODS
A 43-year-old Asian woman was found to have an intrauterine device embedded in the bladder wall during evaluation for chronic pelvic pain and urinary tract infection. She underwent cystoscopic-laparoscopic partial cystectomy, with an uncomplicated postoperative course. She had normal renal function during the follow-up period. This case demonstrates the possibility and safety of performing cystoscopic-laparoscopic partial cystectomy for the removal of a partially implanted intravesical foreign body.
RESULTS
The patient recovered without incident and was discharged 7 days after surgery. No abnormalities were noted in the urine output or renal function in the postoperative follow-up period. No complications due to retrograde flow of carbon dioxide up the ureters or air embolism were noted during the procedure or postoperatively.
CONCLUSIONS
The combination of laparoscopy and air cystoscopy has been shown to be an optimal method for retracting foreign bodies embedded in the bladder wall. Also, air cystoscopy can be used to give doctors a better view in cases in which vision is compromised under water-contrast cystoscopy.

Keyword

Cystoscopy; Intrauterine devices; Laparoscopy; Urinary bladder calculi

MeSH Terms

Adult
Carbon Dioxide
Cystectomy/methods
Cystoscopy/*methods
Device Removal/methods
Female
Foreign Bodies/diagnostic imaging/etiology/*surgery
Foreign-Body Migration/diagnostic imaging/surgery
Humans
Intrauterine Devices/*adverse effects
Laparoscopy/*methods
Tomography, X-Ray Computed
*Urinary Bladder/diagnostic imaging
Urinary Bladder Calculi/diagnostic imaging/etiology/surgery
Carbon Dioxide

Figure

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  Fig. 1 Abdominal computed tomography (A: horizontal section. B: sagittal section) indicating a T-shaped intrauterine device embedded in the bladder wall (red arrow).

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  Fig. 2 Cystoscope equipped with a pressure-control device.

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  Fig. 3 Laparoscopic and air cystoscopic view of the intrauterine device and calculus.

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