Urological assistance during therapeutic pubectomy.

Area of Science:

• Urology
• Orthopedic Surgery
• Surgical Techniques

Background:

• Osteomyelitis pubis is a challenging condition requiring surgical intervention.
• Pubectomy, a procedure to remove part of the pubic bone, carries risks of injury to adjacent urological structures.
• Optimizing surgical exposure is crucial for patient safety during pubectomy.

Purpose of the Study:

• To describe a technique for optimizing surgical exposure during female pubectomy.
• To minimize the risk of injury to the urethra and bladder during pubectomy.
• To present a collaborative approach between urologists and orthopedic surgeons.

Main Methods:

• Three female patients diagnosed with osteomyelitis pubis underwent pubectomy.
• A combined transvaginal and retropubic dissection was performed before bone resection.
• This dissection facilitated complete separation of the urethra and bladder from the surgical site.

Main Results:

• All pubectomy procedures were completed successfully without intraoperative urological injury.
• No postoperative pelvic instability was observed in any patient.
• Pelvic pain resolved in all three patients, with no need for blood transfusions.

Conclusions:

• A combined transvaginal and retropubic dissection technique can enhance surgical exposure during female pubectomy.
• This collaborative urology-orthopedics approach potentially reduces the incidence of bladder and urethral injury.
• The described technique offers a safe and effective method for managing osteomyelitis pubis.