[Fournier's gangrene]

Abstract

The authors present their own experiences with diagnostics and treatment of men with necrotising fasciitis of the scrotum (Fournier's gangrene). During 1995-2001 8 men were treated for the above diagnosis at the Clinic of Urology, Faculty Hospital in Hradec Králové. Six cases were patients with diabetes type II, in one patient we found during basic examinations a large tumour of the sigmoid and one patient was 7 days after total scrotal orchiectomy (because of prostatic adenocarcinoma). Repeated open revision under general anaesthesia was performed in all men with necessary necrectomy, testicles were intact (except a patient after orchiectomy). The infection was spread into the hypogastric area in two patients and in one patient spontaneous rupture of bulbar urethra occurred. By a combination of antibiotic therapy and repeated necrectomies, open wound healing and wet compresses we achieved cure of infection and granulations, which made final scrotal plastic surgery possible. From microbiological point of view it was mixed aerobic and anaerobic flora.