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Case Reports
. 2017:2017:9820245.
doi: 10.1155/2017/9820245. Epub 2017 Jul 17.

Scrotal Abscess Drained by Iatrogenic Urethral Fistula in an Adult Diabetic Male

Marco Stizzo  1 , Davide Arcaniolo  1 , Carmelo Quattrone  1 , Raffaele Balsamo  1 , Marco Terribile  1 , Celeste Manfredi  1 , Vincenzo Mirone  2 , Paolo Verze  2 , Marco De Sio  1
Affiliations
Case Reports

Scrotal Abscess Drained by Iatrogenic Urethral Fistula in an Adult Diabetic Male

Marco Stizzo et al. Case Rep Urol. 2017.

Abstract

A 46-year-old Caucasian male has been transferred to our urology department with a history of septic fever, uncompensated diabetes, pain, and scrotal swelling. On clinical examination, the left inguinal and scrotal area was swollen, tender, and painful; scrotal MR had been performed, showing the catheter tip in scrotal cavity and presence of gas. The case was diagnosed as scrotal abscess with urethroscrotal fistula. He was successfully treated with scrotal incision, drainage, catheter repositioning under fluoroscopic control, antibiotics, and insulin. This patient developed an infection of scrotum, which led to subcutaneous abscess getting worse by a poorly controlled glycemia. In this case, an iatrogenic fistula, caused by wrong catheterization, stops the evolving to a Fournier's Gangrene. Early detection and intervention provide opportunities to improve outcome of this disease.

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Figures

Figure 1
Figure 1
Scrotal MRI (sagittal): urethroscrotal fistula (black arrow) with catheter rolled in the scrotal sac, balloon (white arrow).
Figure 2
Figure 2
Clinical course. IPM, imipenem; TEC, teicoplanin; LVX, levofloxacin; MTZ, metronidazole.
Figure 3
Figure 3
Retrograde cystography at 40th day.
Figure 4
Figure 4
Retrograde urethrography at 10 months.
See this image and copyright information in PMC

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