The presence of multiple vesicocutaneous or urethrocutaneous fistulas can result in the watering-can abdomen or perineum, depending on where the cutaneous openings are found.
Manifestations:
(1) The presence of multiple fistulae between the urinary tract and the skin surface.
(2) A strong bladder contraction results in multiple urine streams, resembling water emerging from a watering can.
(3) The fistulae can be visualized on imaging studies if contrast material is instilled into the bladder prior to emptying.
Risk factors:
(1) urethral stricture, often from untreated gonorrhea or other venereal disease
(2) suprapubic cystostomy
(3) pelvic trauma or surgery
(4) bladder diverticulum
(5) large bladder calculi
(6) neoplasms
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