Gans, by penetrating injuries or, as in our patient, by self-insertion, which is usually a result of eroticism, inquisitiveness or psychiatric illness. buying generic viagra online 1 in cases of self-insertion, psychiatric evaluation has been suggested. viagra patent expiration date usa 2 , 3 a multitude of foreign bodies, including intrauterine devices, medical sutures, hair, wires and artificial urinary sphincters, have been associated with bladder calculi. 1 , 2 , 4 – 9 in our patient, bladder calculi induced by the presence of a foreign body were the result of self-insertion. reviews of viagra daily Our patient’s case was unique for several reasons. generic viagra First, the mild obstructive urinary symptoms and the absence of severe infection for 15 years were surprising given the number of intravesical foreign bodies and the size of the calculi at presentation. Second, it demonstrates how patients with foreign bodies can progress to life-threatening acute renal failure, thus indicating the importance of definitive management with all vesical foreign bodies. Urological history taking had to be stressed to confirm the presenting symptoms because our patient was embarrassed to reveal his urinary history. To our knowledge, no other cases have been reported of foreign body–induced bladder calculi leading to acute renal failure. Conclusion foreign body–induced bladder calculi are a diagnostic and therapeutic challenge. viagra dosage recommendations Our patient’s case demonstrated an atypical and serious presentation that can result years after initial foreign body placement. ​ fig. viagra for sale 5 copper wire, the nidus for bladder stone formation. Footnotes competing interests: none declared. This article has been peer reviewed. overnight delivery for viagra â other sectionsâ–¼ abstract introduction case report discussion conclusion references references 1. Loeser a, gerharz ew, riedmiller h. cheap viagra online Chronic perforation of the urinary bladder by self-inserted foreign body. viagra jelly sachet Int urogynecol j pelvic floor dysfunct. 2007;18:689–90. [pubmed] 2. viagra prescription med Kenney rd. Adolescent males who insert genitourinary foreign bodies: is psychiatric referral required? Urology. 1988;32:127–9. [pubmed] 3. viagra patent expiration date usa Costa g, di tonno f, capodieci s, et al. Self-introduction of foreign bodies into the urethra: a multidi. cheap generic viagra