What Causes Perianal Abscess And WBC In Semen?

Posted on Sat, 22 Nov 2014

Question: hello doctor,
at the beginning of when my symptoms started about 4 months ago, i developed a little bump right next to my rectum.. maybe one inch away. I thought it was a hemorroid and would be resolved over time but the bump has stayed there for 4 months. It is very itchy and painful to touch. My doctor thinks it is an abcess. My only symptoms for the supposed bacterial prostitis i have is dysuria ... no discharge or pain in testicles and no visible signs of any thing else on the surface anywhere. I have been on antibiotics off and on for 3 months. Could it be that it is only this abcess which is giving me these symptoms and i dont have prostitis? my question is... can i have a high WBC count in semen (which i do 7) and it is just the anal abcess causing it? thanks XXXX

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Dysuria is due to refferd pain.

Detailed Answer:
Hello
Thanks for faith and trust that you have shown in me and writing again.

You have perianal abscess since 4 months and painful urination (Dysuria).

Anal sphincter and Urethra sphincter have same nerve supply that is by Pudendal nerve) so whenever there is any pathology in vicinity of anal sphincter (in your case it is anal abscess) one gets pain due to irritation of the branch of Pudendal Nerve that innervates anal sphincter At the same time this irritation is referred to its branch that innervates urethral sphincter giving rise to Dysuria This is called as referred pain

The presence of WBC in semen is due to the infection that has spread to seminal vesicle .

Since you have been taking antibiotics for a long time the semen culture may not detect organisms.

Please note that this abscess will never subside with antibiotics .The only treatment option is to drain the abscess by a qualified General Surgeon. Negligence may result in bursting of an abscess in the anal canal and outside as well that will result in formation of a Fistulous tract which is very cumbersome pathology.

Your dysuria will get resolved once anal abscess is drained .

Hope I have answered your query,Please feel free to ask if you have more questions I shall be happy to help you.

Thanks with Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (1 hour later)

Dr... Your responses have always been so good.... Praying to God that you are right about this... And what I have is not something chronic... So many antibiotics I just feel drained... And yet the burning pain in penis continues... So you think once this is drained I will still need antibiotics for infection in seminal vesicle? And is this abcess continuously feeding this infection? Could I still have infection in the prostate? I have been to 4 urologists here and none made this connection... God bless you doc

Answered by Dr. Dr. P. T. Patil (7 hours later)

Brief Answer:
Draining anal abscess is the best treatment.

Detailed Answer:
Hello
Thanks for follow up.
Drainage of an anal abscess will eradicate infection completely ,You will need antibiotics only for couple of days.

There are no chances of infection in prostate which have not been reflected in investigations done so far.

Please if you ave time post your review about my services on the forum of HGM.

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar