{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:33:22Z","timestamp":1792643602256,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the natural history, reconstructive solutions, and functional outcomes of those men undergoing pubectomy and urinary reconstruction after prostate cancer treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>This study retrospectively identified 25 patients with a diagnosis of urosymphyseal fistula (UF) following prostate cancer therapy who were treated with urinary reconstruction with pubectomy. This study describes the natural history, reconstructive solutions, and functional outcomes of this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 25 patients had a history of pelvic radiotherapy for prostate cancer. The median (interquartile range [IQR]) time from prostate cancer treatment to diagnosis of UF was 11\u00a0(6, 16.5)\u00a0years. The vast majority of men (24\/25; 96%) presented with debilitating groin pain during ambulation. Posterior urethral stenosis was common (20\/25; 80%), with 60% having repetitive endoscopic treatments. Culture of pubic bone specimens demonstrated active infection in 80%. Discordance between preoperative urine and intraoperative bone cultures was common, 21\/22 (95.5%). After surgery, major 90\u2010day complications (Clavien\u2013Dindo Grade III and IV) occurred in eight (32%) patients. Pain was significantly improved, with resolution of pain (24\/25; 96%) and restoration of function, the median (IQR) preoperative Eastern Cooperative Oncology Group Performance Status (ECOG PS) was 3 (2, 3) vs median postoperative ECOG PS score of 0 (0, 1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Endoscopic urethral manipulation after radiation for prostate cancer is a risk factor for UF. Conservative management will not provide symptom resolution. Fistula decompression, bone resection, and urinary reconstruction effectively treats chronic infection, improves pain and ECOG PS scores.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15333","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T23:35:32Z","timestamp":1609976132000},"page":"460-467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Pubectomy and urinary reconstruction provides definitive treatment of urosymphyseal fistula following prostate cancer treatment"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7781-3638","authenticated-orcid":false,"given":"Jack R.","family":"Andrews","sequence":"first","affiliation":[{"name":"Department of Urology Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Hebert","sequence":"additional","affiliation":[{"name":"Department of Urology Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy C.","family":"Boswell","sequence":"additional","affiliation":[{"name":"Department of Urology Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross A.","family":"Avant","sequence":"additional","affiliation":[{"name":"Department of Urology Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanapoom","family":"Boonipatt","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2954-0628","authenticated-orcid":false,"given":"Lucas","family":"Kreutz\u2010Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Bakri","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Houdek","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2339-5925","authenticated-orcid":false,"given":"R. Jeffery","family":"Karnes","sequence":"additional","affiliation":[{"name":"Department of Urology Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyd R.","family":"Viers","sequence":"additional","affiliation":[{"name":"Department of Urology Mayo Clinic and Mayo Medical School Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"224","article-title":"Periostitis of symphysis and descending rami of pubes following suprapubic operations","volume":"37","author":"Beer E","year":"1924","journal-title":"Int J Med Surg"},{"key":"e_1_2_7_3_1","first-page":"165","article-title":"Osteonecrosis, fractures, and protrusio acetabuli secondary to x\u2010irradiation therapy for prostatic carcinoma","volume":"14","author":"Csuka M","year":"1987","journal-title":"J Rheumatol"},{"key":"e_1_2_7_4_1","first-page":"541","article-title":"Osteitis or osteomyelitis of the pubis? 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