Pubic Bone Resection Provides Objective Pain Control in the Prostate Cancer Survivor With Pubic Bone Osteomyelitis With an Associated Urinary Tract to Pubic Symphysis Fistula

Lavien, Garjae; Chery, Godefroy; Zaid, Uwais B.; Peterson, Andrew C.

doi:10.1016/j.urology.2016.08.035

Cited by 26 publications

(20 citation statements)

References 22 publications

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“…As part of pain relief, pubic bone resection has been shown to provide immediate and sustained improvement in pain, along with the long course of antibiotics administered [ 28 ]. In a cohort of 16 patients, a statistically significant decrease in the median pain intensity score was noted, over a median follow-up of 9.4 months, after performing pubic bone resection (5.5 versus 0; P = 0.0005).…”

Section: Discussionmentioning

confidence: 99%

Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy—Case Description with Literature Review

Degheili

Mansour

Nasr

2018

Case Reports in Urology

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Prostate cancer is the most common solid cancer among American men. Although there are various modalities for treatment, including radical prostatectomy among many others, the former is, nevertheless, not without any accompanied complications. Other than the well-known surgical complications such as erectile dysfunction, urinary incontinence, and voiding dysfunction, osteomyelitis of the symphysis pubis is not a well-understood complication, with various hypotheses explaining its pathogenesis. Although osteomyelitis of the pubis symphysis has been reported after endoscopic urological procedures such as transurethral resection of the prostate, it has rarely been reported after robotic surgeries. We hereby report, to the best of our knowledge, the first osteomyelitis of the pubis symphysis, after robotic prostatectomy, in a patient with prostate cancer and no previous radiation therapy.

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Section: Discussionmentioning

confidence: 99%

Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy—Case Description with Literature Review

Degheili

Mansour

Nasr

2018

Case Reports in Urology

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“…Common causes of pubic osteomyelitis are trauma, postoperative complications of gynecology-urology surgery, inguinal-femoral hernia surgery and the influence of adjacent infection foci [2], [4], [5], [6]. Osteomyelitis of the pubic bone is rarely described.…”

Section: Discussionmentioning

confidence: 99%

Pubic osteomyelitis after surgery for perforated colonic diverticulitis with fecal peritonitis: A case report

Kitaguchi

Enomoto

Ohara

et al. 2017

International Journal of Surgery Case Reports

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HighlightsAn early diagnosis of pubic osteomyelitis is difficult to obtain because the symptoms are nonspecific and do not present the typical septic arthritis of a joint.Delayed diagnosis and treatment leads to progressive bone degradation and induces severe complications, resulting in severe pelvic pain and a wide-based gait.A definitive diagnosis by CT and MRI and appropriate antimicrobial therapy combined with surgical treatment are important for pubic osteomyelitis.

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“…Finally, the restricted blood perfusion of the pubic joint space can keep the infection relatively isolated from the bloodstream [40]. This may also be a reason for suboptimal results with systemic monotherapy with corticosteroids or intravenous antibiotics, reported by other authors [15,39]. The unspectacular intraoperative findings in the absence of pus, as well as the clinical absence of fever, malaise, infectious spreading and sepsis, which was observed in our patient series, may also be explained by the restricted blood supply to the symphysis pubis joint space.…”

Section: Appendix: Laboratory Examination and Radiological Workupmentioning

confidence: 99%

Surgical debridement of infected pubic symphysitis supports optimal outcome

Wagner

Hopf

Rommens

2020

Arch Orthop Trauma Surg

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Introduction Infected pubic symphysitis (IPS) is a rare bacterial infection of the pubic symphysis that causes subpubic pain, disability and ultimately permanent immobility. Due to difficult diagnosis, patients present with long-standing complaints and consult several doctors. To date, no validated treatment protocol exists and most patients are treated conservatively with antibiotics. This study was aimed to assess the results after careful surgical debridement and pathogen-specific antibiotic treatment in IPS. Materials and methods A chart review of eight patients with proven IPS was performed. Five of eight patients filled in a specific own-developed questionnaire and could be examined clinically and radiologically at a mean of 13 months (range: 6-30 months) postoperatively. Results There were six males and two females with an average age of 69 years (range: 55-80 years). The mean duration of symptoms before surgical treatment was 10.5 months (range: 1-30 months). There were no complications due to the surgical debridement. There was no recurrence of infection at the pubic symphysis during the follow-up period. The most common pathogen was Pseudomonas aeruginosa in three patients. Mean preoperative pain, measured on the visual analogue scale (VAS, range: 0-10) for the four analysed categories in the five follow-up patients was 7.2, 30 days postoperatively 2.7 and 13 months postoperatively 0.4. There was a steady increase in the quality of life (QoL) 30 days postoperatively and at the 13 months follow-up when compared to preoperative values. Conclusions Surgical debridement is the keystone for treatment of IPS and should be combined with local and systemic antibiotic therapy.

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Pubic Bone Resection Provides Objective Pain Control in the Prostate Cancer Survivor With Pubic Bone Osteomyelitis With an Associated Urinary Tract to Pubic Symphysis Fistula

Cited by 26 publications

References 22 publications

Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy—Case Description with Literature Review

Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy—Case Description with Literature Review

Pubic osteomyelitis after surgery for perforated colonic diverticulitis with fecal peritonitis: A case report

Surgical debridement of infected pubic symphysitis supports optimal outcome

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