Int J Sports Med 2005; 26(4): 303-306
DOI: 10.1055/s-2004-820975
Clinical Sciences

© Georg Thieme Verlag KG Stuttgart · New York

Successful Treatment of Osteitis Pubis by Using Totally Extraperitoneal Endoscopic Technique

H. Paajanen1 , J. Heikkinen2 , H. Hermunen3 , I. Airo4
  • 1Department of Surgery, Central Hospital of Mikkeli, Mikkeli, Finland
  • 2Department of Nuclear Medicine, Central Hospital of Mikkeli, Mikkeli, Finland
  • 3Department of Radiology, Central Hospital of Mikkeli, Mikkeli, Finland
  • 4Diaconess Hospital of Helsinki, Helsinki, Finland
Further Information

Publication History

Accepted after revision: February 5, 2004

Publication Date:
10 September 2004 (online)


Osteitis pubis is characterized by pain, inflammation, and sclerosis in the pubic symphysis. It is often a self-limiting disease in athletes, but persistent pain may occasionally need surgery. Video-assisted placement of extraperitoneal retropubic synthetic mesh to support the damaged area may hasten the healing of this injury. During 1997 - 2002 five elite level male athletes with chronic groin pain associated with osteitis pubis were operated. The diagnosis was based on clinical findings, x-ray, magnetic resonance imaging (MRI), and isotope bone scanning. A 10 × 15 cm polypropylene mesh was placed into preperitoneal retropubic space using video-assisted technique. The pain and return to sport were asked at 1, 6, and 12 months after surgery. Preoperative technetium bone scan revealed an enhanced isotope uptake of pubic bone in each patient. T2-weighted MRI (n = 3) indicated bone marrow edema, which was decreased postoperatively on repeated MRI scans. Periosteal edema and irritation were also seen at operation. No complications were associated with the insertion of mesh. All 5 athletes returned to their sport activites between one to two months after surgery. After one year, no tenderness or pain was observed in the pubic bone. When conservative treatment fails, the placement of retropubic mesh is safe and a mini-invasive method to hasten the rehabilitation of osteitis pubis in selected cases. The postoperative recovery was uneventful, and the patients returned rapidly to their sporting activities.


H. Paajanen

Department of Surgery · Central Hospital of Mikkeli

Porrassalmenkatu 35 - 37

50100 Mikkeli


Phone: + 358443512220

Fax: + 35 81 53 51 22 55