From the Guidelines
Total Hip Arthroplasty and Neurogenic Bladder
Yes, total hip arthroplasty (THA) can potentially cause neurogenic bladder, although it is a rare complication. This is because the surgical procedure can cause nerve damage or irritation, particularly to the nerves that control bladder function, such as the pudendal nerve or the pelvic splanchnic nerves 1.
- Nerve Damage: The surgical procedure for THA can lead to nerve damage or irritation, affecting the nerves responsible for bladder control.
- Symptoms: Patients undergoing THA should be closely monitored for signs of neurogenic bladder, such as urinary retention, incontinence, or difficulty starting to urinate.
- Management: In some cases, medication such as alpha-blockers like tamsulosin 0.4mg daily or anticholinergics like oxybutynin 5mg twice daily may be prescribed to help manage symptoms 1.
- Referral: Patients who experience persistent or severe symptoms should be referred to a urologist for further evaluation and treatment, considering the complexity of neurogenic lower urinary tract dysfunction (NLUTD) and the need for personalized management plans 1.
From the Research
Neurogenic Bladder and Total Hip Arthroplasty (THA)
- There is limited direct evidence linking total hip arthroplasty (THA) to neurogenic bladder, as most studies focus on the causes, management, and complications of neurogenic bladder itself 2, 3, 4, 5.
- Neurogenic bladder is a condition characterized by bladder problems due to a brain, spinal cord, or nerve problem, and its management involves various therapeutic options, including conservative, minimally invasive, or surgical approaches 4.
- While the provided studies do not directly address the relationship between THA and neurogenic bladder, one study mentions a case of bladder wall injury consequent to total hip replacement, suggesting that bladder complications can occur as a result of surgical procedures, including THA 6.
- The current evidence does not provide a clear answer to whether THA can cause neurogenic bladder, as the studies focus on the management and complications of neurogenic bladder rather than its potential causes, including surgical procedures like THA 2, 3, 4, 5.