[A case of osteomyelitis of the pubis after radical prostatectomy: a case report].
ABSTRACT A 74-year-old man visited our hospital, because of high prostate specific antigen (PSA). Retropubic radical prostatectomy was performed for prostatic cancer. Suddenly right inguinal lesion pain appeared at 25 days after operation with disturbance of gait. Pelvic magnetic resonance imaging (MRI) demonstrated inflammatory change in right pubic bone, pectineal muscle, adductor muscle, which suggested the diagnosis of osteomyelitis of the pubis. After long-term administration of antibiotic therapy, osteomyelitis of the symphysis pubis and gait possible. There was no recurrence of osteomyelitis of the symphysis pubis at one year after operation. In addition to our case, we review the 8 cases of osteomyelitis of the pubis after radical prostatectomy previously reported in Japanese publications.
Article: Preventable long-term complications of suprapubic cystostomy after spinal cord injury: Root cause analysis in a representative case report.[show abstract] [hide abstract]
ABSTRACT: ABSTRACT: Although complications related to suprapubic cystostomies are well documented, there is scarcity of literature on safety issues involved in long-term care of suprapubic cystostomy in spinal cord injury patients. A 23-year-old female patient with tetraplegia underwent suprapubic cystostomy. During the next decade, this patient developed several catheter-related complications, as listed below: (1) Suprapubic catheter came out requiring reoperation. (2) The suprapubic catheter migrated to urethra through a patulous bladder neck, which led to leakage of urine per urethra. (3) Following change of catheter, the balloon of suprapubic catheter was found to be lying under the skin on two separate occasions. (4) Subsequently, this patient developed persistent, seropurulent discharge from suprapubic cystostomy site as well as from under-surface of pubis. (5) Repeated misplacement of catheter outside the bladder led to chronic leakage of urine along suprapubic tract, which in turn predisposed to inflammation and infection of suprapubic tract, abdominal wall fat, osteomyelitis of pubis, and abscess at the insertion of adductor longus muscle Suprapubic catheter should be anchored securely to prevent migration of the tip of catheter into urethra and accidental dislodgment of catheter. While changing the suprapubic catheter, correct placement of Foley catheter inside the urinary bladder must be ensured. In case of difficulty, it is advisable to perform exchange of catheter over a guide wire. Ultrasound examination of urinary bladder is useful to check the position of the balloon of Foley catheter.Patient Safety in Surgery 01/2011; 5(1):27.