RESUMO
Trichobezoar is a rare condition whereby a hairball is found in the human stomach or gastrointestinal tract, most frequently in young women, mainly in association with a psychiatric disorder. Trichobezoar cases have also been reported in the bladder and represent a rare complication of foreign bodies, called "hair nidus or hair ball," in patients with chronic catheter. Approximately 10% to 15% of patients on long-term urethral catheter or clean intermittent self-catheterization develop urinary tract stones. In a small minority of cases, bladder stones can develop around a foreign body that was introduced into the bladder. In the literature, there are few cases of foreign bladder bodies that formed stones over a hair nidus. Recognizing this condition can optimize the patient's quality of life. Herein, we present a case of a 71-year-old Caucasian male with a long-term catheter in hypocontractile urinary bladder secondary to injury of pelvic plexus after rectal surgery. He had a bladder stone caused by hair encrusted together. Hair is introduced into the bladder either by adherence to the catheter directly or by overlying the urethral meatus and being pushed internally. Regular hygiene and shaving of pubic area represent effective preventive measures to reduce this kind of complications in patients with chronic indwelling catheter or under a self-catheterization regimen.
RESUMO
A 43-yr-old man with left lumbar pain was diagnosed as having a growing renal angiomyolipoma at imaging. TriPort laparoscopic nephron-sparing surgery (NSS) without ischemia was performed. The TriPort was inserted through a 4-cm pararectal incision, and with the use of 5-mm instruments, left-unclamped NSS was performed and completed in 165 min (blood loss: 180 ml). Postoperative treatment was uneventful with favorable short-term outcomes and high patient satisfaction at 12-mo follow-up. This technique should be attempted in highly selected patients with favorable tumor anatomic features and performed by an experienced laparoscopic team.
