Pages

Thursday, December 12, 2013

Bizarre foreign bodies: Silicone sealant in urinary bladder


Various kinds of foreign bodies in the urinary bladder have been reported in medical literature, including electric wire (ouch!), a ballpoint pen, a thermometer, and a pencil. However, one Korean guy got even more creative - and became the subject of an article published in the Journal of Korean Medical Science in 2012.

The 42-yr-old man sought medical help because of severe right flank pain that reportedly woke him up at night. He had a history of drug treatment for cystitis (an inflamed bladder) 2 years earlier and had used an anti-inflammatory agent for discomfort in the lower abdomen 1 month before coming to the hospital. The flank pain first commenced 10 days prior to presentation, but suddenly became acute on the day of the visit. 

During physical examination, there was tenderness in the angle between the ribs and the spine, as well as tenderness in the right abdomen. A simple pelvic radiography indicated a large radio-opaque lesion approximately 7 cm in diameter in the lower pelvic cavity, and the first suspicion was a bladder or ureteral stone. Abdominal and pelvic computed tomography showed an opaque, tubular lesion in the urinary bladder. At this point, doctors began to suspect a mysterious foreign body, and when they questioned the patient, he finally admitted the truth. Two years earlier, he had used an injector to inject liquid silicone up his urethra. Yes, that gooey polymer sealant which is usually used to fill gaps in window and door frames or to caulk bathtubs. Afterwards, he walked around for two years with a ball of the stuff in his bladder, without telling anyone.

The foreign body was removed using a cystoscope. It turned out to be a convoluted band of brown silicone, approximately 1 meter long (!) and 7 mm thick.



(A) Radiograph showing a mass (arrows) in the pelvic area. (B) Computed tomography (CT) image demonstrating a convoluted lesion in the urinary bladder and a dilated ureter. (C) CT image showing dilated right kidney because of impaired urine outflow. (D) Photograph of the removed foreign body: brown, ca. 1 meter long and 7 mm thick. It was identified as silicone. Image from: Cho et al. (2012)


Every time I look at these photos, a simple question bugs me: what was this grown-up, apparently normal and lucid guy thinking when he injected bathroom caulk up his penis? Was he trying to doctor his erection, or what? Heck, I'm not sure I want to know.


Literature: 

Cho BS, Park KS, Kang MH, Han GS, Lee SY, Cha SH, Kim SJ. (2012) Unilateral Hydronephrosis and Hydroureter by Foreign Body in Urinary Bladder: A Case Report. J Korean Med Sci. 27(6): 704–706. 





No comments:

Post a Comment