Spontaneous Extravasation of Urine from the Anterior Urethra

Abstract

When urine extravasates from the diseased anterior urethra the subcutaneous tissues beneath Colles' and Scarpa's layers are suffused and necrosis of these tissues is inevitable. Traditionally, surgical treatment has been incision and drainage. Despite improvements in systemic antimicrobial therapy mortality rates remain high. Since necrosis of subcutaneous tissue is inevitable and since the extent of suffusion is discernible, we have treated these patients by primary excision of all edematous subcutaneous tissue. Using patients treated conventionally at our own institution as controls we have demonstrated a significant reduction in the mortality rate. We also have demonstrated that certain findings in the initial evaluation of the patient are of value in assessing prognosis.

Urethral stricture

“…In former days it was usually fatal: today it is still not an uncommon sight in African hospitals, where it calls for prolonged and patient plastic surgical reconstruction. The crucial factor is to let out the extravasated urine so that it cannot injure the skin (Weems and Hillis, 1977). If there is any suspicion of perineal extravasation, it should be drained freely, but opinions differ as to the need for an attempt to repair the laceration in the wall of the urethra.…”