Abstract
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.
Keywords
leech - urinary bladder - cystoscopic removal
