Pubic Osteomyelitis After Laparoscopic Simple Prostatectomy: Pubic Bone Resection With Partial Cystectomy

腹腔镜单纯前列腺切除术后耻骨骨髓炎:耻骨切除联合部分膀胱切除术

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Abstract

Osteomyelitis of the pubic symphysis presents a diagnostic challenge, characterized by symptoms of pubic pain and discomfort radiating to the groin, thigh, or hip. Post-prostate surgery occurrences are rare, with a propensity for cancer-related procedures. Conservative antibiotic therapy may prove insufficient, necessitating surgical intervention. This article details a unique case involving Pseudomonas aeruginosa infection, the second most prevalent pathogen. Despite the rarity of the diagnosis, particularly after a benign surgical procedure, timely intervention was hindered, leading to a delayed management course. The case involves a 69-year-old male with a history of benign prostatic hyperplasia who underwent laparoscopic simple prostatectomy. Post surgery, he developed recurrent urinary infection-related symptoms, leading to hospitalization. Diagnostic tools such as CT scans, MRI, and F-18-FDG-PET/CT scan played crucial roles in identifying the inflammatory process. Subsequent surgical debridement, pubic bone resection, and partial cystectomy, followed by an eight-week antibiotic course, led to a favorable recovery. Discussion emphasizes the rarity of pubic symphysis osteomyelitis, particularly after benign surgery, underscoring the importance of imaging and timely intervention. The presented case adds to the limited literature on post-prostatectomy osteomyelitis, emphasizing the need for heightened clinical awareness and consideration of rare complications even in routine surgical scenarios.

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