PURPOSE: Chronic @entity158 after the treatment of @entity263 is often attributed to @entity4421 . We have become aware of another complication, namely fistulation into the pubic symphysis, which is more serious and more common than previously thought. MATERIALS AND METHODS: A total of 16 @entity1 were treated for @entity292 after the treatment of @entity263 between January 2011 and April 2014. Clinical presentation was characterized by chronic, debilitating pubic/pelvic/groin @entity158 in all @entity1 . Diagnosis was confirmed by magnetic resonance imaging. Conservative management was successful in only 1 @entity1 . The remaining @entity1 were treated surgically with excision of the fistulous track and involved symphyseal bone and omentoplasty, followed by reconstruction when feasible. RESULTS: All 16 @entity1 had had radiotherapy as primary treatment (8) or after prostatectomy (8). There were 5 @entity1 (31.3%) who underwent various combinations of brachytherapy, external beam radiotherapy and cryotherapy. @entity1494 developed in 13 @entity1 (81.3%), whose treatment (endoscopic or open reconstruction) resulted in urinary leak leading to @entity292 . Reconstruction was possible in 7 of 15 @entity1 (46.7%) with salvage radical prostatectomy and substitution/augmentation cystoplasty. The other 8 @entity1 (53.3%) underwent cystectomy and ileal conduit diversion. All  @entity1 experienced resolution of symptoms, most significantly the almost immediate resolution of @entity158 . CONCLUSIONS: A high index of suspicion must be maintained in irradiated @entity1 presenting with symptoms suggestive of @entity292 , especially after having undergone treatment of @entity1494 or prostatic urethral stenoses. Although extensive, surgery for @entity292 , with a high risk of morbidity and mortality and a protracted recovery, leads to immediate  and dramatic improvement in symptoms.

Fistulation into the Pubic Symphysis after Treatment of XXXX : An Important and Surgically Correctable Complication.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['Bladder neck contractures', 'bladder neck contractures'] @entity292 :: ('MESH:D005402', 'Disease') :: ['urosymphyseal fistulas'] @entity4421 :: ('MESH:D010000', 'Disease') :: ['osteitis pubis'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'pubic pain']
@entity263 :: (MESH:D011471,Disease) :: ['Prostate Cancer']
