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Ureteroarticular fistula after total hip replacement. A case report
D Schäfer1, G Mattarelli, E Morscher
1Department of Orthopaedic Surgery, University of Basel, Switzerland.
Archives of Orthopaedic and Trauma Surgery
|January 1, 1994
Summary
A rare ureter-acetabular fistula occurred after hip replacement surgery. Prompt diagnosis and nephroureterectomy resolved the patient's hematuria and leg swelling.
Area of Science:
- Urology
- Orthopedic Surgery
- Medical Diagnostics
Background:
- Revision surgery for total hip arthroplasty can lead to rare complications.
- Fistulas between orthopedic implants and the urinary tract are uncommon but serious.
Observation:
- A 69-year-old female presented with intermittent macrohematuria and leg swelling post-hip revision.
- Symptoms suggested a complication related to the total hip prosthesis.
Findings:
- Arthrography and analysis of aspirated fluid (elevated creatinine) confirmed a ureter-acetabular fistula.
- Nephroureterectomy successfully treated the fistula and relieved symptoms.
Implications:
- This case highlights the importance of considering ureter-acetabular fistulas in the differential diagnosis of unusual post-arthroplasty symptoms.
- Early recognition and surgical intervention are crucial for favorable outcomes in such cases.
- The absence of external signs like open sinuses does not rule out internal fistulous complications.