Cystoscopic removal of leeches in the lower urinary tract: our experience.
BACKGROUND
The purpose of this study is to describe the experience of managing leech infestation in lower urinary tract from a tropical country.


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.


RESULTS
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.


CONCLUSIONS
Cystoscopic removal can be a useful technique for the removal of leeches from the urinary tract when saline irrigation fails.
Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh. proftahmina@gmail.com
Tahmina
T
Banu
Tanvir K
TK
Chowdhury
Mahfuzul
M
Kabir
Md Akbar H
MA
Bhuiyan
Kamrun
K
Laila
Nurul
N
Kabir
Md Jafrul
MJ
Hannan
Momtazul
M
Hoque
Subash
S
Mazumder
D000818:Animals; D001459:Bangladesh; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007865:Leeches; D008297:Male; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000627:therapeutic use; D014463:Ultrasonography; D014522:Urethral Diseases / Q000469:parasitology / Q000628:therapy*; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000503:physiopathology; D062885:Urinary Catheters
D012965:Sodium Chloride