Abstract
We present the first case reported in the medical literature of a patient with a spontaneous ventral urethral fistula accompanied by severe infection due to diabetes mellitus. A 34-year-old man with poor controlled adult-onset diabetes mellitus was admitted to our hospital with a large subcutaneous abscess involving the complete penis, scrotum and perineum. The patient did not report any history of any penile trauma or local infection but has experienced transient swelling of the perineal region following urination. Initial surgical treatment consisted of surgical debridement of necrotic tissue. At this time reconstructive surgery was impossible and a suprapubic cystostomy was performed. After 4 months of suprapubic urinary diversion the urethral fistula resolved and function of external genitalia was reestablished. In a follow-up period of 40 months no recurrence occurred. Spontaneous diabetes-associated ventral urethral fistulas are extremely rare and we are not aware of any other published case report.
Highlights
Formation of an urethral fistula is a rare event and is usually a result of infectious complications or due to injury or surgery [1,2]
We present the first case reported in the medical literature of a patient with a spontaneous ventral urethral fistula accompanied by severe infection due to diabetes mellitus
We present the case of a patient with an urethral fistula in the absence of any of the common causes
Summary
Formation of an urethral fistula is a rare event and is usually a result of infectious complications or due to injury or surgery [1,2]. We present the case of a patient with an urethral fistula in the absence of any of the common causes. In this case this complication seems to be related to poorly controlled diabetes. Journal of Medical Case Reports 2007, 1:80 http://www.jmedicalcasereports.com/content/1/1/80 assured that there had been no trauma or foreign body insertion into the urethra His medical history included poor controlled non insulin-dependent diabetes mellitus initially diagnosed about three months earlier. Four months later no urethral leakage was visible upon repeat retrograde urethrogram At this time the suprapubic catheter was removed and the patient was able to urinate without further problems. Normalization of serum glucose level by oral medication or insulin therapy is the basis of every treatment of diabetes related complications
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