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Intraoperative bladder perforation during primary total hip arthroplasty.

ABSTRACT: 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.

SUBMITTER: Konopitski A

PROVIDER: S-EPMC5859462 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Intraoperative bladder perforation during primary total hip arthroplasty.

Konopitski Andrew A Boniello Anthony A Wang Patrick P Shah Mitesh M Old Andrew A Gingrich Kevin K

Arthroplasty today 20170516 1

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, a ...[more]

PMID: 29560394

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