Case reports highlight complications of urethral leak and osteomyelitis in patients after prostate surgery, indicating early intervention improves outcomes.
From these cases, it is seen that patients with this complication often present with difficulty ambulating, urinary retention, pubic symphysis tenderness, and groin pain. Investigations included urine culture, pubic bone culture, imaging (computed tomography cystogram or magnetic resonance imaging of the pelvis), and cystoscopy. Non-surgical management includes urinary diversion and antibiotics and is the first-line treatment. Second-line surgical management includes open prostatectomy, robotic prostatectomy, or sequestration sequestrectomy of pubic symphysis and repair of the prostate. Additionally, early recognition of this complication can lead to significant improvement in patient quality of life.
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Kim et al. (2026) studied this question.
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