Mucoid-producing lesion following hip arthroplasty

A 54-year-old patient with a history of total hip arthroplasty (THA) presented with recurrent bladder infections, gross hematuria, and sediment in urine. The urinary complaints were unresponsive to transurethral resection and partial cystectomy. On further evaluation, a communicating fistulous tract was discovered between the site of hip arthroplasty, ischiorectal fossa, and bladder. Bladder involvement as a morbid delayed complication of total hip arthroplasty is an unusual finding, particularly in the form of a mucoid-producing lesion and vesicoacetabular fistula. Similarly unusual irritative urological symptoms unresponsive to treatment should prompt consideration of potential orthopedic hardware involvement.