{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:10:21Z","timestamp":1756314621246,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,8,11]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>A man in early 40s met with an accident with a complex pelvic fracture and extraperitoneal bladder injury and posterior urethral disruption 16 years ago. He additionally had left lumbar spinal segment mixed nerve injury, resulting in a foot drop. He underwent laparotomy and a diverting cystostomy at the time with a primary perineal urethroplasty a year later. He later developed pseudoarthrodesis of the hip joint, and poorly compliant bladder with complete block at bulbar urethra. A redo anastomotic urethroplasty was performed, hyperreflexive neurogenic bladder was managed with intravesical botox injections and underwent a hip replacement. Having defaulted botox injections, he developed a vesico-acetabulo-cutaneous fistula and the hip prosthesis was explanted. Later he underwent a ileal cystoplasty and a revision hip replacement. Ten years later, he presented with a recurrent fistula due to poor compliance with clean intermittent catheterisation. A challenging exploration with fistula excision was done with a primary bladder repair.<\/jats:p>","DOI":"10.1136\/bcr-2022-250618","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T11:16:07Z","timestamp":1660907767000},"page":"e250618","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Recurrent vesico-acetabulo-cutaneous fistula: lessons to be learnt"],"prefix":"10.1136","volume":"15","author":[{"given":"Pankaj","family":"Wadhwa","sequence":"first","affiliation":[{"name":"Department of Urology, Medanta The Medicity Medanta Institute of Kidney and Urology, Gurugram, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunny","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Urology, Medanta The Medicity Medanta Institute of Kidney and Urology, Gurugram, Haryana, 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