Traumatic Posterior Urethral Fistula to the Hip Joint Following Gunshot Injury: A Case Report

Introduction: Fistula of the Urinary system 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."nCase Presentation: A 37-year-old man was shot with firearm to the superior part of the right pelvis. He underwent delayed reconstruction surgery for urethral rupture. After 10 months of initial injury, he presented with inability to urinate, and history of progressive pain in the right hip joint accompanied by low-grade fever, which started two months after the initial injury. In retrograde urethrography and antegrade cystography, a 5 cm-long stricture and a fistula tract to the right hip joint were detected. Hip x-ray showed evidence of 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."nConclusion: Hip joint contamination with urine following urethro-acetabular fistula may lead to severe and disabling complications such as septic arthritis. We recommend that every clinician should have these fistulas in mind as a complication of penetrating urethral injury; every attempt should be made for their early diagnosis and prompt treatment should be performed to prevent further complications."nKeywords: Urethral Fistula, Hip Joint, Gunshot Injury, Urethro-Acetabular Fistula, Trauma