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Type 2 diabetic. Stopped urination. Noticed painful abscess on perineum. How to get relief?

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30 year old male with type 2 diabetes trouble starting and stopping urination. Abcess in perenium area that bursts open periodically. Occasional sharp perenium pain and occasional groin pain. Tenderness in the testicles. Problem ongoing off and on for several years.
Posted Tue, 12 Mar 2013 in Men's Health
Answered by Dr. V. Sasanka 32 minutes later
It looks like you should get yourself checked for evidence of any sinus or fistula from the anal area which usually manifests as recurrent formation of abscess. These are abnormal tracts lined by normal cells in areas where they should not be existing. If there is indeed a sinus or a fistula, the tract needs to be excised completely by a minor surgical procedure. On occasions, reduced body defence mechanisms can cause a similar picture where the patient gets periodic infection by an organism called staphylococcus even without a sinus or fistula.
Inflammation in the perineum can cause significant discomfort, and the resultant pelvic pain does inhibit urination, and occasionally we have had to catheterize patients till the inflammation ceases so that they can again void naturally. If however the difficulty in urination does persist despite resolution of perineal problem, you might have to get additional tests done such as an ultrasound scan of your pelvis and kidneys, a uroflowmetry and evaluation of post-void residue to ensure you do not have what we term 'bladder neck obstruction'.
This is usually not an issue, especially in young adults, and can be easily remedied by administration of medications such as Flomax.
On rare occasions, diabetes can cause damage to the nerves supplying your bladder, and this can cause your bladder to lose its strength, and such patients find they are passing urine slowly, with some amount of strain, and some urine is left behind in the bladder after completion of voiding. this however manifests after the patient has had diabetes for over 10-20 years.
Hope I have been able to help you..
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Follow-up: Type 2 diabetic. Stopped urination. Noticed painful abscess on perineum. How to get relief? 7 minutes later
What should I ask my family doctor to test for? Do you think prostatis is an issue here because the problem has been ongoing for several years.
Answered by Dr. V. Sasanka 4 hours later
Perineal abscesses almost never originate from prostate. Looks like your problem is more likely from an anal or rectal issue causing pus in a localized area which keeps repeatedly coming up to the surface as a boil or abscess.
Hope your diabetes is under good control.
Take plenty of fiber in diet, make sure you are not constipated.
You can also try 'sitz baths' - where you immerse your bottom in a tub of tepid water to which you can add a few drops of anti-septic solution, and sit relaxedly for a few minutes. This is supposed to be quite useful.
Above answer was peer-reviewed by
Follow-up: Type 2 diabetic. Stopped urination. Noticed painful abscess on perineum. How to get relief? 8 hours later
Do you think the abcess is causing my urination issues or are they two unrelated problems?
Answered by Dr. V. Sasanka 1 hour later
As I said earlier, perineal and anal pain can disturb urination to a fairly significant extent, and thus the true extent of a urinary problem can often be gauged only after the resolution of the perineal complaint. A painful abscess might cause reflex inhibition of urination.
A relatively rare problem could be an abscess associated with urethra, i.e. the urinary passage, also can present with pain in perineum with swelling, but such patients also do mention that they have difficulty in passing urine, which is often extremely prolonged, in drops, with pus in urine. It looks unlikely in your case.
IOf after complete resolution of your abscess, you still persist having difficulty in voiding, you can probably have a couple of tests like Ultrasound for bladder and kidneys, a uroflowmetry to assess the way you void urine, urine analysis and culture and take it from there.
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