World Journal of Urology

, Volume 34, Issue 2, pp 275–280 | Cite as

Pubic symphysitis after transurethral resection of the prostate

  • C. Ziesel
  • S. Frees
  • C. Thomas
  • R. Stein
  • R. Gillitzer
  • J. W. Thüroff
Original Article

Abstract

Purpose

Pubic symphysitis (PS) after urological operations is uncommon. This is a systematic single-institution review of patients with transurethral resection of the prostate (TUR-P) with the aim to determine the incidence of PS after TUR-P and to identify a risk profile.

Materials and methods

In the past 15 years, 12,118 transurethral operations were performed in our department, 33.4 % (n = 4045) were TUR-P, and 84.6 % (n = 3421) had routine suprapubic trocar placement. A systematic retrospective analysis identified 12 patients, who developed PS (0.297 %).

Results

Median age was 69.5 years (64–83). All patients had voiding difficulties. Urine culture had been positive in three cases. All 12 TUR-Ps were monopolar resections, and n = 11 patients had a suprapubic trocar. Median resection weight was 47.5 g (10–100). Two patients had a perforation of the capsule. Histopathological examination revealed chronic prostatitis in nine cases. After 1.0 ± 1.2 months, all patients developed pain in the pubic region. All patients underwent MRI, which suggested PS. Symptomatic and antibiotic medications were administered. Final outcome was resolution of symptoms in all patients after 3.8 ± 5.6 months. No patient retained voiding difficulties.

Conclusion

PS remains a rare complication after TUR-P. We could not identify a single cause for developing PS. In our study, suprapubic trocar placement (11/12), chronic prostatic inflammation (9/12), previous UTI (3/12) and extended resection (2/12) were overrepresented. Inflammatory, thermic and/or surgical damage of the capsule may be causative. Patients require antibiotic and symptomatic medication. However, prognosis for remission is excellent.

Keywords

TUR-P Pubic symphysitis Inflammation Complication 

Abbreviations

bid

Bis in die/twice daily

CFU

Colony forming units

CT

Computed tomography

E. coli

Escherichia coli

ESBL

Extended spectrum beta-lactamase

kg

Kilogram

MRI

Magnetic resonance imaging

NSAIDs

Non-steroidal anti-inflammatory drugs

PS

Pubic symphysitis

sqm

Squaremeter

TUR

Transurethral resection

TUR-P

Transurethral resection of the prostate

UTI

Urinary tract infection

WBC

White blood count

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This retrospective study has been performed in accordance with the ethical standards of the Declaration of Helsinki. The manuscript does not contain prospective clinical studies.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • C. Ziesel
    • 1
  • S. Frees
    • 1
  • C. Thomas
    • 1
  • R. Stein
    • 1
  • R. Gillitzer
    • 2
  • J. W. Thüroff
    • 1
  1. 1.Department of Urology, Medical CenterJohannes Gutenberg University, MainzMainzGermany
  2. 2.Department of UrologyHospital DarmstadtDarmstadtGermany

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