Migrated bullet in the bladder presenting 30 years after a gunshot wound to the gluteal region

Introduction. In current practice, genitourinary trauma secondary to gunshot wounds is relatively rare. Even less common is the migration of a bullet decades after the trauma, with only a few cases described in the literature. This article illustrates the sporadic occurrence of bullet migration into the urinary system. It underscores the importance of prompt diagnosis and timely treatment, as the time period from the trauma occurrence to symptom onset can be extremely long. Case outline. We present a case of a retained bullet that migrated into the bladder 30 years after the injury in the gluteal region. This is the longest period from the occurrence of the gunshot wound to the onset of symptoms described in the literature. After failed attempts at retrieving the bullet endoscopically, a small cystostomy was performed with successful evacuation of the foreign body. Conclusion. The time gap from the occurrence of the trauma to the appearance of symptoms can complicate the diagnostic and treatment process. The history of a gunshot wound in this region suggests the exclusion of bullet or shrapnel migration into the bladder, regardless of the time distance since the trauma. Although migration is rare, it highlights the need for both short-term and long-term follow-up of patients with retained bullets and shrapnel

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