Osteochondroma of the pubic symphysis causing hematuria: a case report and literature review

Abstract

Background Osteochondroma is the most common benign bone neoplasm and is sometimes referred to as osteocartilaginous exostosis. The symptoms caused by osteochondroma are rare, especially the urogenital complications. Therefore, this tumour is sometimes misdiagnosed. Case presentation This report described a 70-year-old woman with hematuria who was initially misdiagnosed with a bladder tumour in the outpatient department by a urologist. However, during cystoscopy, we found that the mass did not resemble a bladder tumor. Multidisciplinary approach with careful analysis of the imaging data suggested the diagnosis of osteochondroma. Open surgical excision of the mass was done and histology confirmed the diagnosis of benign osteochondroma. After 6 months of follow-up, the patient was still asymptomatic. Conclusions This case illustrates that hematuria is caused by not only urogenital disease but also osteochondroma. We present this case to draw the attention of clinicians to osteochondroma of the pubic symphysis.

Urinary Tract Infections in Elderly Patients: A 10-Year Study on Their Epidemiology and Antibiotic Resistance Based on the WHO Access, Watch, Reserve (AWaRe) Classification

“…The number of available reports on the epidemiology of UTIs in the elderly is scarce. Hrbacek et al reported on the resistance of uncommon urinary isolates, mainly members of the CES ( Citrobacter-Enterobacter-Serratia ) and PPM ( Proteus-Providencia-Morganella ) groups, Acinetobacter and Pseudomonas [ 10 ]: the overall prevalence of these pathogens was 4.65% in a 9-year (2011–2019) study period, with male patients being disproportionally more affected (76.8%); the mean age of patients were 70.3 and 69.2 years for males and females. The majority (50–80%) of the surveyed isolates were resistant to aminopenicillins and I-II.…”

“…generation cephalosporins, while resistance rates to III. generation cephalosporins, fluoroquinolones, aminoglycosides, carbapenems, nitrofurantoin and SXT were around 5–15%, 20%, 6–33.3%, 10%, 90% and 10–30%, respectively [ 10 ]. The increased diversity of urinary pathogens in patients with advanced age was further verified by the findings of Kot et al, noting the increasing importance of Enterococcus spp.…”

“…These microorganisms possess an advantageous mix of physiological adaptability and the relevant virulence factors (such as a polysaccharide capsule, urease enzyme, fimbriae, pili) to withstand the sheer forces and to thrive on the urinary epithelium [ 8 ]. Overall, Escherichia coli (or uropathogenic E. coli [UPEC]) is the most frequently isolated species in UTIs [ 9 ]; nevertheless, in hospitalized and/or immunosuppressed patients, non-conventional urinary pathogens are increasingly present [ 10 , 11 ]. The antimicrobial therapy of UTIs has become increasingly challenging, due to worrying developments in antimicrobial resistance (AMR) worldwide [ 12 ]; clinicians are often left with scarce therapeutic choices, as multidrug-resistant (MDR) bacteria are progressively more common in both community-associated and healthcare-associated UTIs [ 13 ].…”

Quality of service and continuous quality improvement in voluntary medical male circumcision programme across four provinces in South Africa: Longitudinal and cross-sectional programme data

“…Findings from previous studies showed that the majority of AEs were procedure related [ 18 ]. Young age groups mostly experience moderate to severe AEs that are related to surgical procedures compared to prepex method [ 19 , 20 ]. Evidence also indicate that the majority of AEs were associated with infections and this frequently affected young age groups [ 13 , 20 , 21 ].…”

Ectopic bone formation causing chronic pubis symphysis pain: successful management with resection and pubic fusion

“…Bone ectopic formation is a rare, progressive skeletal process, not very well described in the literature. Potential underlying mechanisms may be related to chronic overload including repetitive or excessive traction and compression forces, resulting in joint instability4 16–18 or recurrent microtrauma causing reactive bone formation 18 19. The cellular pattern of this bone formation is different than the fracture healing or normal development pattern 18…”