Urine extravasates from the bladder or urethra and collects in the layers of the perineum or in the prevesical space (cave of Retzius).
CAUSES:
TYPES:
It may be superficial or deep.
1.Superficial: It is due to either bulbar urethral injury or due to bursting of periurethral abscess after urethral stricture. Once urine extravasates due to full thickness disruption of the urethra anteriorly, it collects in superficial perineal space. This space is a closed cavity all round except anteriorly where it communicates with scrotal subcutaneous tissue deep to fascia Colles, penis between superficial fascia and deeper Buck’s fascia, in the anterior abdominal wall deep to Scarpa’a fascia. It does not spread to thigh and ischiorectal space as Scarpa’a fascia is attached firmly to fascia lata of thigh. Superficial perineal space is closed above by inferior fascia of perineal membrane; below by fascia of Colles; laterally by ischiopubic rami. It is open and communicating only anteriorly.
Entire scrotum, penis and often lower abdominal wall are swollen containing urine. It is painful; patient cannot pass urine through urethra; severe pain and shock due to pelvic injury. Often sepsis occurs and skin sloughs of leading into urinary fistulas.
Abscess formation,
sinus/fistula formation.