Gross hematuria: a complication of intrapelvic cement intrusion in total hip replacement

Four patients with gross hematuria and dysuria following intrusion of methylmethacrylate into the pelvic cavity after total hip replacement are described. This is a rare, benign complication which generally occurs 7-14 days after surgery and subsides promptly with symptomatic treatment. The diagnosis can be made on a simple radiography of the pelvis which shows the radiopaque cement as a mass intruding with the pelvic cavity. On the urogram it frequently abuts against or produces an extrinsic impression on the urinary bladder. This complication is very likely a result of the exothermal reaction during polymerization of the methylmethacrylate.