Abstract
IntroductionUrinary system fistula to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury.Case presentationA 37-year-old Iranian Balochi male was shot with a firearm in the superior part of his right pelvis. He underwent primary closure on the same day. Ten months later, he developed urinary retention. He underwent retrograde urethrography and antegrade cystography which showed a stricture measuring 5 cm in length. There was also a history of progressive pain in the right hip joint accompanied by low grade fever which started 2 months after the initial injury. Hip X-ray showed evidence of an acetabular cavity and femoral head destruction diagnostic of complicated septic arthritis. The patient subsequently underwent reconstructive surgery for the urethral stricture and urethral fistula via a transperineal approach followed by total hip arthroplasty.ConclusionHip joint contamination with urine following a urethro-acetabular fistula can lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should keep these fistulas in mind as a complication of penetrating urethral injury and every attempt should be made for their early diagnosis and prompt treatment.
Highlights
Urinary system fistula to the hip joint is a rare complication
We recommend that every clinician should keep these fistulas in mind as a complication of penetrating urethral injury and every attempt should be made for their early diagnosis and prompt treatment
The membranous urethra which passes through the pelvic floor and voluntary urinary sphincter are the portion of posterior urethra most likely to be injured [1]
Summary
Urinary system fistula to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury.Case presentation: A 37-year-old Iranian Balochi male was shot with a firearm in the superior part of his right pelvis. Urinary system fistula to the hip joint is a rare complication. We report a case of delayed posterior urethral fistula to the hip joint following penetrating gunshot wound injury. Case presentation: A 37-year-old Iranian Balochi male was shot with a firearm in the superior part of his right pelvis. He underwent primary closure on the same day. Ten months later, he developed urinary retention. The late complications of posterior urethral injury are bleeding, urinary extravasation, pelvic abscess, and destruction of the posterior urethra, urinary diversion, urethral fistulas and urethral stricture [2]. Peri-urethral or perivesical urinary extravasations seen (page number not for citation purposes)
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