Successful endoscopic management of an unusual bladder foreign body using a novel technique

Foreign body (FB) insertion into the bladder is uncommon in the paediatric population. Management of embedded bladder foreign bodies is not widely discussed in the literature and is limited to straight objects such as knitting needles. We report a novel technique for management of a coat-hanger hook embedded in the bladder wall of a 10-year-old girl. The patient presented with left distal ureteric obstruction and pyonephrosis. Although the expectation was that the FB extraction and management of the ureteric injury would both require open procedures, the case was successfully managed using minimally invasive techniques. A paired wire helical stone-retrieval basket was used to disengage the hook of the FB from the bladder wall and safely extract it cystoscopically. The ureteric injury resulted in a stricture which was successfully managed with endoscopic balloon dilatation 2 months later following a period of ureteric stenting. The patient was followed up with serial ultrasounds and clinical review over a 3-year period and has had no further issues. This case demonstrates safe endoscopic management of a rare complex bladder foreign body in a paediatric patient using a novel technique.