Abstract
Urosymphyseal fistula (USF) is a rare but serious complication following robot-assisted radical prostatectomy (RARP), frequently associated with osteomyelitis of the pubic symphysis and causing significant morbidity. We present a case of a 66-year-old patient who developed USF with osteomyelitis after RARP, characterized by persistent pelvic pain and urinary symptoms. MRI was crucial in diagnosing the fistula and osteomyelitis, guiding a successful multidisciplinary intervention, including robotic-assisted surgery. Early diagnosis, advanced imaging modalities, and collaborative surgical management remain essential for optimal patient outcomes. Continued advancements in diagnostic and therapeutic strategies are necessary for effective management of USF.