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19–22 APRIL, 2017, BARCELONA, SPAIN
16:21–16:26
S3-18 (VP)
SELF-INSERTION OF MULTIPLE CHEWING-GUMS
THROUGH URETHRA
Alberto MANTOVANI, Chelsy LASSO BETANCOR, Naima SMEULDERS
and Pankaj MISHRA
Great Ormond Street Hospital for Children, Paediatric Urology, London, UNITED KINGDOM
PURPOSE
This video shows the endoscopic retrieval of a large bladder mass after self-insertion of multiple
chewing-gums through urethra for sexual pleasure.
MATERIAL AND METHODS
A 14-year-old boy, with high-functioning autism, presented with dysuria, frequency and macroscopic
haematuria. He had put in around 40 chewing-gum pieces through the urethra 3 days before, pass-
ing out some of them with micturition. Physical examination revealed non-palpable bladder and
normal penis with glanular hypospadias. Ultrasound scan reveal a 5x4x4 cm spherical, mobile mass
lying at the level of the bladder neck. A cystoscopy was planned.
RESULTS
A white spherical mass of chewing-gums clumped together was found, with features of cystitis.
A 20Fr cystoscope sheath was used. Cold irrigation fluid made the mass firm and easier to remove
in piece-meal using the biopsy forceps. The patient was discharged the day after the procedure. He
was asymptomatic at 3-month follow up.
CONCLUSIONS
FB into the bladder during adolescence usually underlie an on-going psychological problem. Clinical
presentation and the type of FB help to decide the appropriate approach. In case of chewing-
gum, if symptoms are well controlled, a planned semi-urgent endoscopic approach seems to be
a reasonable option. The piece-meal removal of the mass can be time-consuming and an alterna-
tive approach should be planned and discussed pre-operatively with the patient. The cystoscopic
approach alone was successful in our case.
16:26–16:45
Discussion