Management of Periurethral Abscess in a Diabetic 47-Year-Old Male: A Case Report
- 1 Urology Department, King Khaled Hospital, Hail, Saudi Arabia
- 2 Radiology Department, King Khaled Hospital, Hail, Saudi Arabia
- 3 Urology Department, Prince Abdelmohsen Hospital, Al-Ula, Saudi Arabia
Abstract
Background: Periurethral abscess is an uncommon but life-threatening urological emergency, particularly in immunocompromised patients. If not managed promptly, it can progress to necrotizing fasciitis (Fournier’s Gangrene). Case Presentation: A 47-year-old male with poorly controlled Type 2 Diabetes Mellitus (HbA1c 11.4%) presented with perineal pain, scrotal swelling, and dysuria. Examination revealed a fluctuant, tender mass. Imaging (Ultrasound and MRI) confirmed a localized periurethral collection within the corpus spongiosum. Management: The patient received aggressive fluid resuscitation, insulin therapy, and broad-spectrum antibiotics, followed by urgent surgical incision and drainage (I&D). Wound cultures grew Escherichia coli . Outcome : Postoperative recovery was uneventful. Follow-up MRI showed complete resolution, and the patient remained asymptomatic at three months. Conclusion: High clinical suspicion and early surgical intervention are vital in diabetic patients to prevent morbid complications like Fournier’s gangrene.
- Tariq, A., Stewart, A.G., Desai, D.J., Britton, S., Dunglison, N., Esler, R., et al . (2022) Periurethral Abscess Etiology, Risk Factors, Treatment Options, and Outcomes: A Systematic Review. Current Urology , 17, 100-108. https://doi.org/10.1097/cu9.0000000000000159
- Blaschko, S.D., Weiss, D.A., Odisho, A.Y., Greene, K.L. and Cooperberg, M.R. (2013) Proximal Bulbar Periurethral Abscess. International Brazilian Journal of Urology , 39, 137-138. https://doi.org/10.1590/s1677-5538.ibju.2013.01.17
- Kachare, M., Alamgir, K. and Mane, N. (2022) Periurethral Abscess in Corpus Spongiosum Diagnosed on Ultrasonography. Journal of Medical Ultrasound , 30, 135-137. https://doi.org/10.4103/jmu.jmu_185_20
- Alwaal, A., Blaschko, S.D., McAninch, J.W. and Breyer, B.N. (2015) Management of Periurethral Abscess. Urology Case Reports , 3, 1-3.
- Kharde, S.N., Anuradha, A.K. and Soumya, S.S. (2025) Urinary Tract Infection in Diabetic Patients: Etiology and Antibiotic Sensitivity. Journal of Contemporary Clinical Practice , 11, 347-353.
- Meng, F., Yu, T., Xie, M., Chen, M. and Chen, X. (2025) Postoperative Wound Microbiota in Diabetic Patients with Perianal Abscess: A 16s rRNA Gene Sequencing Study. BMC Microbiology , 25, Article No. 756. https://doi.org/10.1186/s12866-025-04459-6
- Otta, S., Swain, B. and Bhoi, P. (2020) Microbiological Analysis of Urinary Tract Infection in Diabetic Patients. International Journal of Research in Medical Sciences , 8, 4410-4416. https://doi.org/10.18203/2320-6012.ijrms20205315
- Tesfaye, N.A., Demessie, M.B., Hassen, M., Solomon, T., Andualem, A., Gebreegziabher, T.L., et al . (2025) E . coli as a Uropathogen in Patients with Diabetes Mellitus, Its Prevalence and Antimicrobial Resistance Profile in Ethiopia: A Systematic Review and Meta-Analysis. BMC Infectious Diseases , 25, Article No. 1276. https://doi.org/10.1186/s12879-025-11714-8
- Yumlembam, B.D., et al . (2026) Prevalence, Demographic Distribution, and Antimicrobial Resistance Patterns of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Urinary Tract Infections: A Cross-Sectional Study in a Tertiary Care Hospital in Manipur, India. Cureus , 18, e101302.