Urological assistance during therapeutic pubectomy

Purpose: A technique is described to optimize exposure during female pubect omy to minimize injury to associated urological structures. Materials and Methods: Three females with diagnosed osteomyelitis pubis und erwent pubectomy. Before resection of the bone, the patients underwent a fo rmal combined transvaginal and retropubic dissection. This dissection allow ed complete freeing of the urethra and bladder from areas of orthopedic res ection and optimized surgical exposure. Results: All operations were completed successfully with no incidence of in traoperative urological structure injury and no postoperative pelvic instab ility. None of the patients required intraoperative or postoperative blood transfusions. Pelvic pain resolved in all 3 patients. Conclusions: Using a combined transvaginal and retropubic technique, the ur ologist may assist the orthopedic surgeon at the time of pubectomy. This te chnique potentially minimizes the incidence of vesical and urethral injury.