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Osteomyelitis pubis after radical gynecologic operations.

U B Hoyme, H K Tamimi, D A Eschenbach

    Obstetrics and Gynecology
    |March 1, 1984
    PubMed
    Summary

    Osteomyelitis of the pubis is a rare complication following pelvic surgery. Early diagnosis and treatment, including antibiotics and potentially surgery, are crucial for patient recovery and reduced hospital stays.

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    Area of Science:

    • Infectious Diseases
    • Surgical Oncology
    • Orthopedic Surgery

    Background:

    • Osteomyelitis of the pubis is a serious complication that can occur after radical gynecologic and pelvic exenterative surgery.
    • This condition presents unique challenges in diagnosis and management due to its location and association with extensive surgical procedures.

    Observation:

    • Five cases of pubic osteomyelitis following major pelvic surgery were analyzed.
    • Common symptoms included pain and tenderness at the pubic symphysis and impaired ambulation.
    • Diagnosis was typically delayed, with an average interval of 13.6 weeks between surgery and identification.

    Findings:

    • Abnormal erythrocyte sedimentation rate and alkaline phosphatase levels were frequently observed.
    • Radiological imaging, including X-rays, bone scans, and gallium scans, proved valuable for diagnosis.

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  • This complication significantly prolonged hospital stays, by an average of 5.6 weeks for vulvectomy patients and 10-24 weeks for pelvic exenteration patients.

    • Implications:

    • Effective treatment involves a combination of intravenous and oral antibiotic therapy.
    • Surgical debridement of necrotic bone is essential for successful management.
    • Addressing pubic osteomyelitis is critical for optimizing patient outcomes and reducing healthcare resource utilization after complex pelvic surgeries.