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Watering-can perineum is the result of multiple fistulae extending from the urethra to open within the perineum. In these patients, urine can exit through these perineal openings 1,2. The fistulae can be detected with voiding cystourethrography, however, the definite cause can be determined with appropriate history, urinalysis, urethroscopy and biopsy 1.
The urethroperineal fistulas can result as sequelae of traumatic or chronic inflammatory strictures. There are classically seen in gonorrheal infections, but can also be seen in tuberculosis, schistosomiasis, and Crohn disease 1.