Pubic symphysitis in the post-urological surgery setting: A case report and literature review

Infectious pubic symphysitis is a rare form of osteomyelitis, typically occurring after pelvic or urological surgery. We report the case of a 60-year-old man who developed acute pubic symphysitis following transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. He presented with severe pelvic pain, fever, and gait difficulty. MRI revealed bone marrow edema of the pubic symphysis, and urine culture identified Proteus mirabilis. The patient was treated successfully with a 6 week antibiotic course, including 2 weeks of intravenous ceftriaxone followed by oral therapy, resulting in complete clinical recovery. This case underscores the importance of considering infectious pubic symphysitis in patients with persistent pelvic pain after urological procedures. Early diagnosis using MRI and targeted antibiotic therapy are key to preventing complications and ensuring favorable outcomes.