Transurethral migration of vesical gossypiboma following open prostatectomy: a case report and review of the literature

Abstract

Gossypiboma refers to a retained surgical sponge within the body after a surgical procedure. It is commonly reported in the abdominal cavity and is rare in the urinary bladder (vesical gossypiboma). There are only a few reports of vesical gossypiboma in the literature, and patients often present long after the initial surgery. Features of recurrent urinary tract infections (UTIs) are common symptoms of vesical gossypiboma, but transurethral migration is a rare manifestation. We present a case of vesical gossypiboma with transurethral migration in a 64-year-old patient who underwent an open trans-vesical prostatectomy 3 months before visiting our hospital. He was repeatedly treated for recurrent UTIs until the diagnosis of vesical gossypiboma was finally confirmed using cystourethroscopy. We successfully removed the retained gauze via open bladder exploration. Gossypiboma can easily be overlooked, and we urge urologists to maintain a high index of suspicion to diagnose similar cases promptly.

Keywords: prostatectomy; recurrent UTI; surgical sponge; transurethral migration; vesical gossypiboma.

Figure 1

Cystourethroscopy showing a retained spongiform structure in the urethra.

Figure 2

A piece of surgical gauze protruding through the suprapubic cystostomy site after trial of antegrade cystoscopic removal (A) and postoperative picture showing the removed surgical gauze (B).