Mucoid-producing lesion following hip arthroplasty.

Area of Science:

• Urology
• Orthopedic Surgery
• Medical Complications

Background:

• A 54-year-old patient with a history of total hip arthroplasty (THA) experienced recurrent urinary tract infections (UTIs), gross hematuria, and urinary sediment.
• Standard urological treatments, including transurethral resection and partial cystectomy, failed to resolve the patient's symptoms.

Observation:

• Further investigation revealed a fistulous tract connecting the hip arthroplasty site, ischiorectal fossa, and the bladder.
• The fistula presented as a mucoid-producing lesion within the bladder.

Findings:

• This case highlights bladder involvement as a rare and severe delayed complication of THA.
• The formation of a vesicoacetabular fistula is an unusual presentation of THA complications.

Implications:

• Unexplained irritative urological symptoms, especially when refractory to treatment, should raise suspicion for orthopedic hardware complications.
• This underscores the importance of considering non-urological origins for persistent urinary issues in patients with prior orthopedic surgery.
• Early recognition and diagnosis of such fistulas are crucial for effective management and patient outcomes.