[Vesico-acetabular fistula occurring 10 years after total hip replacement]

An 85-year-old female, who had had a total hip replacement for osteoarthritis in 1985, presented with gross hematuria in June 1995. Cystoscopy revealed a non-papillary sessile tumor in the right side wall of the urinary bladder with a crateriform opening on the top. Computed tomographic (CT) scan and excretory urography demonstrated a fistulous communication between the bladder and the acetabular bed filled with cement. The biopsy of the mass lesion suggested inflammatory granuloma with powdered cement. Since the lesion was composed of internal fistula, and was not accompanied with infection, the patient was treated conservatively. No external fistula had formed during the 5 months of observation.