Pseudotumor Formation in the Bladder as a Late Complication of Total Hip Replacement

Abstract

A 44-year-old man presented to our urological department in May 1995 with intermittent painless gross hematuria 2 months in duration, and a history of right and left hip replacement for alcoholic induced avascular necrosis of the femoral head in 1984 and 1988. He had experienced an episode of bladder tamponade due to blood clot before admission to the hospital. Cystoscopy revealed a 20 x 20 x 20 mm. protruding tumor in the right lower lateral bladder wall. Transurethral resection of the tumor was performed, and histopathological study showed only inflammatory cell and abscess formation without evidence of malignancy. Hematuria recurred 3 months later. Repeat cystascopy revealed a locally recurrent bladder tumor, which was resected. Histopathological analysis showed inflammation. Excretory urography revealed a normal collecting system except for a piece of bone cement found inside the right pelvis in close contact with the bladder wall (see figure). The tumor recurred 3 months later. Partial cystectomy was performed and a piece of bone cement was found penetrating into the bladder wall. Right hip revision arthroplasty was performed 4 months later with no evidence of recurrent bladder tumor.