Why is an audit needed?
The perineum and scrotum have loose tissue, through which pus quickly spreads, and with anaerobic flora, it turns into necrotizing fasciitis (Fournier’s gangrene), which is life-threatening. Therefore, the abscess here is not simply opened, but revised: the incision is expanded to the boundaries of healthy tissue, necrosis is excised, the cavity is washed, drainage is installed and, if necessary, the revision is repeated after 24–48 hours. In case of paraurethral abscess against the background of a stricture, urine is drained by a cystostomy, and the urethra is operated on after the inflammation has subsided. Broad-spectrum antibiotics are administered intravenously.
Abscesses in urology
Purulent foci in urological practice occur against the background of urinary tract infection, obstruction, diabetes mellitus, after manipulation: prostate abscess as a complication of prostatitis, abscess of the perineum and scrotum, groin boils, abscess and paranephritis of the kidney with pyelonephritis. Signs are increasing throbbing pain, temperature with chills, thickening and redness, and with prostate abscess - urinary retention and pain during defecation. The formed abscess does not resolve with antibiotics and requires opening or drainage.
After opening
The cavity is drained until the purulent discharge stops (2–7 days), daily dressings and rinsing are performed, and the antibiotic is selected based on culture. The wound heals by secondary intention in 1–3 weeks. It is imperative to eliminate the cause: correction of diabetes, treatment of urinary tract infections, and in case of obstruction, drainage of the urinary tract. Control ultrasound confirms the disappearance of the cavity.
