We report a rare case of vesico-acetabular fistula due to an improperly treated pelvic fracture with urinary stone formation in the joint cavity. This complication was related to an unrecognized mechanism of bladder wall entrapment in the acetabular floor defect during weight bearing. This situation led to several mistreatment decisions in our case and should be always considered by urologists dealing with patients after major pelvic trauma. In this case report, we analyze the publications related to this problem, discuss the main mechanisms of bladder wall damage after acetabular fracture, and propose tips for diagnosis and treatment.

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were calculated to see association with categorical variables and the groups.RESULTS: A total of 172 adult patients with ureteric stones >1cm were included in this study. 87 patients in the TFL group with a mean age of 37.9þ-8.8 and 85 in the Ho:YAG group with a mean age of 39.4þ-10.5 (p[0.34). There was no difference regarding BMI (26þ-3.6 vs 26þ-3.7)(p[0.96), Co-morbidity (16% vs 24% with multiple comorbidities)(p[0.49), anaesthesia type using general or spinal (57% vs 55%) (p[0.77), stone volume (1.6þ-0.5 vs 1.5þ-0.5)(p[0.41), or basket use (15% vs 15%)(p[0.95). Interestingly, the TFL group took longer to perform, with higher operative time than the Ho:YAG group (81.7þ-42.2 vs 67þ-35.1 (p[0.016)). This was likely due to the fact the TFL group did have more multiple stones requiring lithotripsy than the Ho:YAG group, however this was not statistically significant, but clearly, clinically significant whereby there was a 27% vs 19% multiple stones rate (p[0.23). There was no difference in the SFR (95% vs 96% (p[0.72)), second look ureteroscopy (14% vs 8%) (p[0.25)) or early or late complication rates, 1% vs 4% (p[0.3) and 0% vs. 1% (p[0.31), respectively. All patients were stone and complication free on follow up.CONCLUSIONS: TFL has proven its efficacy and safety with high SFR and low early and late complication rates. TFL ureteroscopic lithotripsy took longer to perform than Ho:YAG, probably due to having a higher stone burden, however statistically not significant.