内視鏡下での膀胱異物（粘土様異物）摘出：症例報告

Urethral foreign bodies are uncommon clinical entities typically associated with psychiatric disorders or self-erotic stimulation. They present unique challenges, especially when involving malleable materials.

A 26-year-old male presented with urinary retention and brown urethral discharge after inserting an 8 cm clay-like foreign body. Cystoscopy revealed migration to the bladder. Initial bedside flexible cystoscopy under local anesthesia removed 40 % of the material using a 4.5 mm basket. Complete extraction was achieved in the operating room using a 17 Fr rigid cystoscope under general anesthesia. The patient received prophylactic antibiotics and was discharged uneventfully with oral antibiotics and analgesics.

Management of urethral foreign bodies requires consideration of object composition and location. In this case, the malleable clay-like material presented unique challenges but was successfully managed using endoscopic fragmentation techniques. This avoided more invasive open surgical intervention while effectively addressing the clinical presentation. Literature documents various foreign objects in the urethra, but clay-like materials are less commonly reported and present specific challenges due to their malleable nature and fragmentation potential.

Prompt endoscopic intervention can successfully manage even challenging cases of migrated urethral foreign bodies. A multidisciplinary approach addressing both physical and psychological aspects is essential for comprehensive care and prevention of recurrence.