Supra pubic, groin and muscle pain after prostectomy

by Carol Hart

Lighten up as you cross the femoral artery and nerve.

Lighten up as you cross the femoral artery and nerve.

I really hope you can help me as I am at my wits end with worry re my husband.

On the 4th of May he had open prostatectomy for benign enlarged prostrate and apart from high temp post op, which he was given ciprofloxacin for he recovered really well, he's 70 but a fit seventy.

Day 11 post op we went to hospital for removal of clips and supra pubic catheter, which I had in for 3 years due to retention of urine which also led to kidney disease. Two days later he developed muscle pain all over, sweating with temp went to hospital given antibiotics for urine infection, has been back twice; had CT scan of pelvic area and apart from small collection nothing was seen. Consultant said he wished there had been an abscess then at least they would have a cause. He spent 4 days in hospital but still can not walk unaided, uses crutches, has difficulty lifting his foot over steps, can only sleep on his back; his left leg "falls" out of bed and he can't get it back in without lifting it.

I am so afraid of him developing a DVT or PE I have encouraged him to ride a 3 wheeler bike, which is ok apart from his unsteady gait, which seems worse when cycling. Then I encouraged him to walk in village where we live part with crutches part without; when we got back home 2hrs later !! he was exhausted and in lots of pain so I think walking has made it worse. Have you any suggestions as to what exercises would benefit him. I have been a critical care nurse (now retired ) for 27 years but I have exhausted every option I can think of; my latest theory is something to do with his symphyis pubis/pelvic ring. Thank you in anticipation.

Hello Carol,
I would ask for an orthopaedic opinion. The question is whether this is related in some way to the prostate surgery, or is a hip condition.

I'm interested in the leg falling out of bed and him being unable to get it back; is he unable to lift the leg because of pain, or paresis of the muscles?

In the CT of the area, was there any comment on the hip joint?

With him lying on his back, using a little oil, run your thumb from the ASIS through the groin and down the medial thigh; how does it compare with the right side.

Whilst sitting, can he raise his thigh off the chair? Weak, or painful; where?

Lying on his back, if he pulls the knee to the chest is it painful and stiff in the groin? If he drops his knee into the lotus position?

Using a needle, prick the lateral thigh; compare sides. Is there a difference?

Obviously I haven't a clue, being unable to examine him, but these are the preliminary thoughts that would be going through my mind.

If you live in the Dordrecht area, see if you can make an appointment with Dhr Glen Potgieter; otherwise there are many excellent chiropractors in Nederland.

Is there any lower back or sacroiliac joint pain?

Let me have some answers.

Dr B

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Aug 19, 2017
Osteomyelitis after prostate surgery
by: carol

Thanks for the suggestions anyway re my husband.
Culture results came back which showed Pseudomonas Infection !! of his pubic bone, everyone has apologised for delay in coming to a diagnosis, apparently it's rare and they have never seen it before! My husband remains on IVAB also morphine pain. He's now walking well and, thanks to having appropriate analgesia, he has little pain. Once again thank you for advice.

Hello Carol,
Alas nosocomial infections are not uncommon but at least you live in a country where it was discovered, acknowledged, diagnosed and treated.

Tomatoes and avocados are the prostate's best friends; for the lycopene and sitosterol; then selenium in foods such as broccoli and mushrooms; even if he doesn't still have one.

Hopelijk gaat het goed in the toekomst.

Dr B

Jul 25, 2017
Infection post prostatectomy
by: Carol

Concerning my earlier post and problems my husband had post prostatectomy, since CT scan which only showed small collection and some inflammation but not enough to cause the problems my husband had.

Since then he has been referred to Neurologist and Rheumatologist. Neuro referred my husband for MRI Scan as she felt it was to do with surgery. The report showed, not a small collection but moderate one, inflammation of his pubic bone and infection.

We have now been referred back to the urologist for IVAB, then oral long term, also aspiration of fluid behind pubic bone to ensure no infection of bone.

Hello Carol,
It's as feared a medical problem; there are a great many large muscles attached to the pubes; any pubic bone infection would make walking very painful, as in a fracture, in fact.

I wish you both well; chiropractic alas has no role to play, but a healthy diet is vital at this time especially.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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