PMC10326616_01
Pelvic radiography demonstrated the presence of a radiopaque, needle-like foreign body within the posterior urethra. (A) The anteroposterior view. (B) The lateral view. L, left.
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F1
A plain x-ray of the pelvis revealed a linear radio-opaque foreign body below the symphysis pubis overlying penile soft tissue shadow, which was highly similar to a sewing needle shadow (Figure 1). A Maryland forceps was used to grasp and extract the needle, which was then removed through the right working port (Figure 2E, Supplementary Video S1).
Operative images. Cystoscopy revealed a sharp sewing needle lodged in the posterior urethra mucosa (A). Illustration showed the needle (marked in red color) migrating into the pelvic region during a digital rectal examination (B). Laparoscopy revealed the needle was identified near the peritoneal reflection over the fundus of the bladder (C). Laparoscopy revealed the peritoneum was incised approximately 5 mm using scissors (D). Laparoscopy revealed the needle was grasped and extracted through a Maryland forceps (E). The needle was measured approximately 45 mm in length (F).
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F2
During cystoscopy, a sharp sewing needle was discovered lodged in the posterior urethra mucosa (Figure 2A). Unexpectedly, the needle was pushed into the pelvic region, wedged between the prostatic urethra and the rectal ampulla (Figure 2B). After careful inspection of the anterior reflection of the peritoneum over the fundus of the bladder, a needlelike black foreign body was identified, which had not penetrated through the peritoneum yet (Figure 2C). Following an approximately 5 mm incision of the peritoneum using scissors, the distal part of the needle was visualized directly (Figure 2D). A Maryland forceps was used to grasp and extract the needle, which was then removed through the right working port (Figure 2E, Supplementary Video S1). The needle was measured approximately 45 mm in length (Figure 2F).
Voiding cystourethrography confirmed normal urethra and bladder of the patient.
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F3
After confirming normal urethra and bladder through a voiding cystourethrogram (VCUG) on postoperative day 14 (Figure 3), the Foley catheter was removed at the outpatient clinic.