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Intraoperative bladder perforation during primary total hip arthroplasty
Journal article   Open access   Peer reviewed

Intraoperative bladder perforation during primary total hip arthroplasty

Andrew Konopitski, Anthony Boniello, Patrick Wang, Mitesh Shah, Andrew Old and Kevin Gingrich
Arthroplasty today, v 4(1), pp 40-43
16 May 2017
DOI: https://doi.org/10.1016/j.artd.2017.03.008
PMID: 29560394
url
https://doi.org/10.1016/j.artd.2017.03.008View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Bladder malformation Bladder perforation Case Report Total hip arthroplasty Total hip replacement
We present a unique case of bladder perforation occurring intraoperatively during primary total hip arthroplasty. It is suspected that the patient's aberrant bladder anatomy, with idiopathic erosion of the quadrilateral space, predisposed the patient to bladder injury. Several preoperative risk factors for bladder injury were identified in the literature. These factors include cemented acetabular components, previous history of hip arthroplasty, history of pelvic trauma or intrapelvic surgery, and poor bone quality. Management of bladder injury, should it occur, includes bladder decompression with a Foley catheter, antibiotic administration, hemodynamic monitoring, and urology consult with close follow-up. This case reinforces the importance of urologic preoperative evaluation for anatomic variations of the bladder. In such cases, intraoperative Foley catheters to prevent distension may reduce the risk of perforation.

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