Muhammad Rafique.
Vesical Gossypiboma.
J Coll Physicians Surg Pak Jan ;13(5):293-5.

Gossypiboma (retained surgical sponge) is an iatrogenic complication. It is infrequently reported in literature because of legal implications setting up a vicious cycle of non-anticipation and misdiagnosis. Four cases of vesical gossypiboma following transvesical prostatectomy are presented. Clinical presentation, diagnostic aspects and preventive strategies are discussed.

Case Report: A 70 years old man presented with complaints of increased urinary frequency, dysuria, suprapubic pain, intermittent fever with rigors. He had transvesical prostatectomy 6 years back in a peripheral hospital. He had repeated postoperative urinary tract infections and one episode of urinary retention. His physical examination was unremarkable. On urinalysis he had pyuria and urine culture showed profuse growth of Escherichia coli. Sonography suggested 4.2 x 4.7 cms calculus in the urinary bladder. An x-ray KUB showed faintly radio-opaque shadow in the bladder area. In urethrogram, the contrast material was seen to have gone within the `stone`. Provisional diagnosis of retained surgical gauze was made. Patient underwent cystoscopy that confirmed the presence of surgical gauze with overlying calcification in the urinary bladder. Two surgical gauzes were removed from the urinary bladder via cystostomy. Postoperative recovery was unremarkable.

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