Osteomyelitis of the Pubic Symphysis as a Complication of Bladder Neck Suspension Procedure with Use of Bone Anchors: A Case Report

Tomoaki Koakutsu

doi:10.4172/2161-1149.s16-002

Abstract

Bladder neck suspension procedure using bone anchors in the pubic bone is employed as the standard treatment for stress urinary incontinence. A 76-year-old woman who had an osteomyelitis of the pubic symphysis following this procedure is presented. She complained of lower abdomen, suprapubic, and left groin pain after she had received an operation for urinary incontinence. The pain persisted and gradually led to gait disturbance. Hematology showed mild inflammation, plain radiograph and computed tomography of the pelvis revealed osteomyelitis of the pubic symphysis and retropubic abscess. Bone anchors and the attached suture material were removed, necrotic bone was curetted. After the surgery, her pain decreased and urinary incontinence remained improved. Osteomyelitis of the pubic bone is uncommon entity that must be recognized in elderly women who received an operation for stress urinary incontinence.

Highlights

Osteomyelitis of the pubic bone is a rarely described entity [1,2]
We report on a case that had a osteomyelitis of the pubic symphysis after this procedure successfully treated operatively
Leach and Appell performed this procedure in 125 patients, and removal of the bone anchor was required owing to infection in only 1 patient, and the other 1 patient required drainage of a pelvic abscess related to suprapubic catheter placement, but the development of osteomyelitis is unclear [5]

Summary

Introduction

Osteomyelitis of the pubic bone is a rarely described entity [1,2]. Most cases are proceeded by urological or gynecological surgery [2,3]. Bladder neck suspension procedure using bone anchors in the pubic bone is a commonly performed procedure for the treatment of stress urinary incontinence which is the most common form of urinary incontinence in women [4,5,6]. As this procedure is a transvaginal surgery, it has been reported to be less invasive and causes a lower incidence of complications, and it is employed as the standard treatment.

Results

Conclusion