Watering can perineum – a forgotten complication of gonorrhoea

Abstract

In the modern era of broad spectrum antibiotics, urethral fistulae (watering can perineum) is one of the forgotten sequelae of chronic gonococcal infection. We report a 20-year-old unmarried male with gonococcal urethritis and two sinuses in the scrotum (watering can perineum). The micturating and retrograde urethrogram revealed mucosal irregularity and extravasation of contrast medium at the junction of bulbous and membranous urethra. Recent worldwide emergence of multidrug resistant strains of gonococci give rise to alarm. In the present scenario of HIV pandemic, ineffective treatment of patient or partner with gonorrhoea may result in development of these complications.

Iatrogenic watering-can perineum and osteomyelitis of pubic ramus as a complication of post-urethral calculus removal UTI

“… 5 The reported latent period between the original gonorrheal infection and the development of these sequelae can be a few months to 50 years. 6,9 Emphysematous periurethral abscess has been reported in diabetic patients. 7,10 …”

A novel approach to the repair of urethrocutaneous fistulae arising after abdominoperineal anorectal resection

“…Urethrocutaneous fistulae have also been described as a "watering-can" perineum. 4 Management of persistent perineal sinuses follows a stepwise approach from least to most invasive. Conservative measures include antibiotics, local wound care, vacuumassisted closure, 2 fibrin glue, 5 and hyperbaric oxygen therapy.…”