Cystoscopic removal of leeches in the lower urinary tract: our experience.

INTRODUCTION

The purpose of this study is to describe the experience of managing leech infestation in lower urinary tract from a tropical country.

MATERIALS AND

METHODS

Medical records (January 2002 to December 2010) of children with history of leech infestation in the urinary system, admitted in the Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong, Bangladesh were reviewed. All patients underwent saline irrigation through urethral catheter. When saline irrigation failed, cystoscopic examination was done with removal of leeches by flexible graspers. Follow-up was done 2 weeks later.

RESULT: The study included 117 patients. Age ranged from 4 to 12 years. Male and female ratio was 3.7:1. All patients had per urethral bleeding. 51 (43.6%) patients had suprapubic pain. All children underwent saline irrigation through urethral catheter. Spontaneous expulsion occurred after saline irrigation in 57 (48.7%) patients. The expelled leeches were alive in 11 cases; dead in 46 patients. Cystoscopic removal of leeches was done in 60 patients (51.3%). In the cystoscopic group, 54 of the removed leeches were dead and 6 were alive.

CONCLUSION

Cystoscopic removal can be a useful technique for the removal of leeches from the urinary tract when saline irrigation fails.