Pubic Bone

SmilingBluEyes · Aug 21, 2002

Hmm not sure about that....I know things stretch and accomodate, but not sure about this. OUCH! Anyone w/more expertise can answer this?

Mkue · Aug 21, 2002

originally posted by natalieboo
hi! another one of my birdbrain questions. is it possible for the pubic bone to seperate and cause pain from the privy parts to the top of the pubic bone?

i think i'm asking that right.. well, if anyone has any comments! :kiss

gosh, i've never heard of this happening, now i'm curious too. :eek:

Natalieboo · Aug 21, 2002

Ok, the deal here is I have a woman who is due in Feb and she is complaining of an excrutiating pain right there. Her doctor isn't taking her seriously. It's so bad she cannot walk, well she can, but it hurts really bad that she'd rather not. Her doc gave her tylenol 3's but she is concerned about taking them.

Anyways I want to comment that if I know the pain she is talking about, I had it about 2 weeks after I had my daughter. It was so bad I went to emerg, and the OB on call could say nothing except that the bones could have gotten seperated during pushing - and then just said I would not even be able to sit if that was the case. She then gave me tylenol 3's as well. My best way to describe it is that it hurt from my pee-hole (ok I dont know the medical term for it!!) to the top of that pubic bone and I think thats what this woman is feeling. Mine ended up going away a few weeks later.

So has anyone heard of this? I KNOW this exists but I have no idea what to call it. Almost feels like a muscle down there has been pulled or something. I am not even this woman's doula, but she really needs some emotional support. She is seeing another doc on Friday and I just wanted to see if you nurses could relate her situation with any patients you have seen..

Thanks!

Sleepyeyes · Aug 21, 2002

I was having some weird pains after my fifth child was born; RIGHT THERE especially during sex.....if you know what i mean. I know it was nerve pain, and even the pelvic exam about sent me through the roof, but the doc denied I was having pain and wanted to presecibe freakin' Valium for my 'nerves".... a female too... :rolleyes:

delirium · Aug 21, 2002

I'm not an expert, but it sounds like a neuromuscular pain rather than a skeletal one.

If your bones truly were separated, wouldn't there be some sort of obvious deformity, crepitus, or something?

delirium · Aug 21, 2002

Originally posted by Natalieboo
Ok, the deal here is I have a woman who is due in Feb and she is complaining of an excrutiating pain right there. Her doctor isn't taking her seriously. It's so bad she cannot walk, well she can, but it hurts really bad that she'd rather not. Her doc gave her tylenol 3's but she is concerned about taking them.

Anyways I want to comment that if I know the pain she is talking about, I had it about 2 weeks after I had my daughter. It was so bad I went to emerg, and the OB on call could say nothing except that the bones could have gotten seperated during pushing - and then just said I would not even be able to sit if that was the case. She then gave me tylenol 3's as well. My best way to describe it is that it hurt from my pee-hole (ok I dont know the medical term for it!!) to the top of that pubic bone and I think thats what this woman is feeling. Mine ended up going away a few weeks later.
Thanks!

Natalie,

Its called your urethral meatus.

:cool:

bagladyrn, RN · Aug 21, 2002

The pain you're referring to after your baby was can be cause by a separated symphisis pubis. There is an area of cartilige in the center that can separate during delivery and cause extreme pain. Definitive diagnosis is by x-ray, but one of the signs to look for is that pain is lessened if the woman walks backward instead of forward because this pulls the 2 sections away from each other rather than rubbing. An abdominal binder worn low around the hips can also help if this is the cause of the pain.

I haven't really seen this during pregnancy though.

delirium · Aug 21, 2002

Originally posted by bagladyrn
The pain you're referring to after your baby was can be cause by a separated symphisis pubis. There is an area of cartilige in the center that can separate during delivery and cause extreme pain. Definitive diagnosis is by x-ray, but one of the signs to look for is that pain is lessened if the woman walks backward instead of forward because this pulls the 2 sections away from each other rather than rubbing. An abdominal binder worn low around the hips can also help if this is the cause of the pain.
I haven't really seen this during pregnancy though.

That's interesting, baglady.

How is it repaired? Will it grow back together like the cartilage in a broken nose? Does the binder help it to do that?

Is this common after delivery? Or perhaps only during a delivery with substantial CPD?

OBNURSEHEATHER · Aug 21, 2002

Originally posted by MsPurp
Is this common after delivery? Or perhaps only during a delivery with substantial CPD?

Rebecca, this is one of those threads you shouldn't be reading when you're in a "thinking about my future and having kids" kind of mood.

I've personally never had a patient voice this kind of pain to me. I do know that there is some cartilage between these bones to allow a little give..... but actual seperation? I hadn't heard that. But I guess anything is possible.

Now in my experience, it's that pesky little coccyx that gets in the way. I've had a few broken tailbones in my few years.

Heather

SmilingBluEyes · Aug 21, 2002

agree w/heather here. i have never had anyone complain of a separated pubic bone pain...but there have been a few broken coccyxes (however the heck ya wanna spell that). that ismuch more common, i think and it will give first in severe CPD and other dystocia cases, i would think. but hey, i am no expert here.

ADN 2002 · Aug 22, 2002

The first patient I took care of during my OB clinical in nsg school had a separation of the symphysis pubis. This poor woman didn't speak a syllable of English, and I had the worst time trying to communicate to her what had happened... She screamed any time she tried to move! I don't remember what kind of pain meds she was on, but it wasn't near enough for what had happened.

I'd give anything to see that x-ray though...

:eek: