Urinary Extravasation and Periurethral Phlegmon: Clinical Analysis of 100 Cases

From 1963 to 1985, 63 periurethral abscesses were treated in 47 men. The records were reviewed to characterize the natural course of the disease. The most common predisposing factors were a history of gonorrhea, previous periurethral abscess and urethral stricture disease. Treatment consisted of abscess drainage, suprapubic urinary diversion and intravenous antibiotic therapy, consisting of an aminoglycoside and a cephalosporin. Mortality was 1 of 63 patient hospitalizations (1.6 per cent). Improved survival over historical cohorts is attributed to the availability of better antibiotics and medical support.

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Periurethral Abscess

Walther

Mann

Finnerty

1987

Journal of Urology

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Spontaneous Extravasation of Urine from the Anterior Urethra

Weems

Hillis

1977

Journal of Urology

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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.

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Periurethral Phlegmon: Posterior Rupture Through Colles‘ Fascia

Allen

1965

British Journal of Urology

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SUMMARY Although urologists are familiar with the classical pathways of spread of fluid beneath Colles' fascia, it is not commonly appreciated that the periurethral phlegmon, by virtue of its ability to induce vascular thrombosis, ischeemia and necrosis of restraining fascial barriers, may disseminate by routes not expected from anatomical studies alone. Two cases demonstrating posterior extension into the buttocks have been presented and the seriousness of the disease has been emphasised. Recognition of such a complication is of more than academic interest since recovery may be dependent upon drainage of these ancillary areas.

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Urinary Extravasation and Periurethral Phlegmon: Clinical Analysis of 100 Cases

Cited by 3 publications

References 8 publications

Periurethral Abscess

Periurethral Abscess

Spontaneous Extravasation of Urine from the Anterior Urethra

Periurethral Phlegmon: Posterior Rupture Through Colles‘ Fascia

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