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Periurethral abscess can cause sudden pain and often interfere with the excretory functions of the body. It therefore qualifies as a medical emergency. Periurethral abscess requires emergency medical care and attention as it can lead to damage to the genitals. In extreme cases, it can trigger nephrolithiasis, extensive necrotizing fasciitis and perforate Buck's fascia.
Abscess are an outcome of our bodies inflammatory response to certain infections and usually seen as pus collection on the surface of the body. Periurethral abscess is the abscess or pus formation seen on the urethra which connects the genitals with the bladder.
Causes of periurethral abscess: Periurethral abscess can be a result of many diseases of the urethra or periurethral area. Also chronic ulceration or inflammation is considered a risk factor. Abscesses in general occur when pus cells accumulate at a particular spot and the immune response generates healthy cells to contain the pus cells at that spot. This often leads to lumpy or nodular formations containing the pus. E. coli, enterococcus species, proteus mirabilis, morganella morganii, fournier’s gangrene, pseudomonas aeruginosa are some of the infections that cause such abscesses.
Staphylococcus infections: Staphylococcus bacteria are known to cause such infections. These infections often come through contaminated food and water. Often if any foreign bodies, such as heavy dust or mud particles, enter the urethra then these bacteria would accumulate around the foreign body leading to pus formation. Subcutaneous infections or boils can be observed in such cases.
Urinary tract infections: Urinary tract infections can be caused due to variety of bacteria, viruses and fungi. These often cause inflammation, appearance of boils and pus.
Urethral strictures: Obstructions to the urethral canal often lead to accumulation of bacteria, virus and fungi. This obstruction can be due to disease, infections and injuries to the tract.
Non gonococcal urethritis: Bacteria like haemophilus vaginalis, chlamydia trachomatis and mycoplasma genitalium, Viruses like herpes simplex viruses and certain parasites may cause non gonococcal urethritis. It can lead to obstruction in the urethra and abscesses in the region.
Other causes: Injuries such as in accidents, knife or bullet wounds, sudden trauma, injuries during surgical procedures while using urinary catheter or a cystoscope and other instruments, can lead to periurethral abscesses. Also infections and inflammatory response to gastric disorders or digestive system disorders like inflammatory bowel disease, gastro intestinal disease etc. can lead to such ulceration, scarring and pus formation. Sexually transmitted diseases such as gonorrhea and gonococcal urethritis too are considered a cause of periurethral abscesses. In men, the disease is one of the reasons for penile emergencies.
Symptoms of periurethral abscess: Severe symptoms of periurethral abscess often manifest themselves suddenly and require emergency medical care. Symptoms of periurethral abscess are,
- Pain in the urethral region often accompanied by abdominal pain, tenderness and sensitivity to touch near the genital region.
- Burning sensation, itchiness, inflammation and reddening on the genitals and scrotal sacs, often with presence of swelling or boils on the genital region.
- Feeling of constriction during urination or incomplete urination or restricted passing or no urination at all.
- Seeing white or yellowed discharge and often red or dark urination.
These symptoms must be treated as a medical emergency after a quick diagnosis of the patient's condition.
Medical emergency diagnosis: Diagnosis of a periurethral abscess may be needed to be done on an emergency basis. Diagnostic techniques like urine tests, blood tests, and stool tests may be conducted in a medical emergency. But in emergencies, faster diagnosis is done using radiographic and endoscopic techniques. These include cystoscopy and urethrography. Cystoscopy involves inserting an endoscopic tube with a minute video camera into the urethral region. Urethrography is done using a foley catheter and a radiographic substance that can be traced on x-ray or magnetic resonance imaging scans. A mild anesthetic is used for the observation. These emergency diagnosis procedures can be carried out in 15-20 minutes. Both of these techniques can point injuries and abscess formations inside and outside the urethral region. You are required to drink a lot of liquids before and after diagnosis to clear the bladder.
Medical emergency treatment: Treatment of periurethral abscess can be done using antibiotics targeting the removal of bacteria, viruses or fungi that caused the pus formation. At times the abscess may be drained out using specialized needles and catheters. Surgical procedures such as urethrotomy, urtheroplasty and debridement may be carried out to retain healthy tissues and remove the affected portions.
Prevention of periurethral abscess: Prevention of periurethral abscess is possible if you maintain a healthy diet along with regular work out. Including fruit and vegetable juices in your diet and drinking lots of water too can avoid periurethral abscess. But the best way to fight periurethral abscesses is to make sure you boil your water or drink water from purifiers and ensure that food you eat is clean and properly cooked
Periurethral abscess thus can lead to a medical emergency. At such times, maintain your composures and inform your doctor or the hospital about your symptoms so that quick action can be taken as soon as you reach the hospital. Take good care after the emergency treatment to avoid recurrence of periurethral abscess.
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