Comparative characteristics of pregnancy-related symphysis pubis dysfunction

The problem of an acceptable choice of the method of delivery for symphysis pubis dysfunction is relevant in modern obstetrics. Since the incidence of this condition varies between 1 in 300 and 1 in 30,000 pregnancies. And such a large variation in the frequency of symphysis pubis dysfunction is explained by the lack of a clear terminology for this disease, pathogenesis, and uniform diagnostic criteria. Purpose of the study. Analysis and comparative characteristics of pregnant women with pubis symphysis diastasis and clinical dysfunction of the pubis symphysis and without it. Material and methods. A retrospective analysis of 1210 birth histories and exchange cards of pregnant women in the period from 2015 to 2019. Results and discussion. In the group with clinical manifestations of pubic symphysis dysfunction, with overweight and obese of I, II, III degrees, as well as with diseases of the blood, cardiovascular system and endocrine disorders. And the group without clinical manifestations of pubic symphysis dysfunction consisted of multigravida with normal body weight. Conclusions. Vaginal delivery preferred by method of delivery for pregnant women with or without clinical manifestations of pubic symphysis, associated with minimal risk of pubis symphysis rupture. Keywords: pubis dysfunction, pregnancy, delivery.

Pelvic injury is not just pelvic fracture

Pelvic trauma is complex, most of current work centres around pelvic haemorrhage and fractures. It is important to remember that there is more anatomy in the pelvis than bones and vessels. A 29-year-old male patient was admitted after an Road Traffic Collision (RTC) where his motorbike T-boned a car. He was noted to have a traumatic dislocation of his right testicle, which spontaneously reduced in the emergency department and he was admitted for scrotal exploration and observation. Due to difficulty in mobilising postoperatively, he underwent an MRI, which showed diastasis of his pubis symphysis as well as left-sided adductor tendon rupture, not evident on his initial CT scan, and underwent pelvic fixation. Why should an emergency physician be aware of this? This case emphasises the alternate differentials with pelvic trauma in a haemodynamically stable patient, and the requirement for continuous reassessment in patients failing to improve.

Symphysis Pubis Osteomyelitis: An Uncommon Complication after Robotic Assisted Radical Prostatectomy—Case Description with Literature Review

Prostate cancer is the most common solid cancer among American men. Although there are various modalities for treatment, including radical prostatectomy among many others, the former is, nevertheless, not without any accompanied complications. Other than the well-known surgical complications such as erectile dysfunction, urinary incontinence, and voiding dysfunction, osteomyelitis of the symphysis pubis is not a well-understood complication, with various hypotheses explaining its pathogenesis. Although osteomyelitis of the pubis symphysis has been reported after endoscopic urological procedures such as transurethral resection of the prostate, it has rarely been reported after robotic surgeries. We hereby report, to the best of our knowledge, the first osteomyelitis of the pubis symphysis, after robotic prostatectomy, in a patient with prostate cancer and no previous radiation therapy.

Symphysis Pubis Osteomyelitis with Bilateral Adductor Muscles Abscess

Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA), which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain.