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Case Reports
. 2013;66(3):331-4.
doi: 10.5173/ceju.2013.03.art22. Epub 2013 Nov 18.

A three-year review of the management of Fournier's gangrene presented in a single Saudi Arabian institute

Atif Katib  1 , Mohammad Al-Adawi  1 , Bassem Dakkak  1 , Amani Bakhsh  1
Affiliations
Case Reports

A three-year review of the management of Fournier's gangrene presented in a single Saudi Arabian institute

Atif Katib et al. Cent European J Urol. 2013.

Abstract

Introduction: Fournier's gangrene (FG), is a rare life threatening urologic emergency that requires immediate admission of metabolic stabilization and surgical debridement. The mortality rate ranges from 16% to 40%. This study was conducted to investigate the reasons behind the excellent survival rate in our center.

Materials and method: A retrospective analysis of the medical records of 20 FG cases from January 2010 to January 2013 was conducted. Data was collected on patients' comorbidity, survivals, Fournier's severity index (FSI) at presentation, length of hospital stay (LOS), the number of intensive care unit (ICU) and operating room (OR) entries, the total phalli and testes removed, colostomies created, and cystostomies performed.

Results: All 20 cases (100%) collected for the study survived. All patients were male. The median age of the patients was 55.95 years (39-78 year). Only one patient (5%) was admitted to ICU post-operatively. Penile amputation was carried out in three of the 20 cases (15%). The total number of OR entries was 34 (average of 1.7). A majority of 12 patients (60%) were diabetic. A total of six testes were extirpated from the study group. None of the patients required colostomy creation. Only one patient (5%) required a cystostomy tube insertion. FSI was 5.65 ranging from 0 to 14. The average length of hospital stay was 22.3 days.

Conclusion: In contrast to what is published in the literature, FG is not rare in our center. Perfect survival rate owes to the moderate severity of the cases treated, but mostly to the urgent surgical intervention with extensive debridement.

Keywords: FSI; Fournier's gangrene; debridement; necrotizing fasciitis; urologic emer; urologic emergency.

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Figures

Figure 1
Figure 1
Case 1. FG showing black gangrenouse penis preoperatively.
Figure 2
Figure 2
Case 2. FG shows dusky scrotum with macerated penile skin.
Figure 3
Figure 3
Case 5. FG at 4th day post op. before bedside debriedment.
Figure 4
Figure 4
Case 4. FG where penis is involved.
Figure 5
Figure 5
Case 6 FG severe perineal and scrotal gangrene.
Figure 6
Figure 6
Case 3 FG when partial penictomy is performed.
See this image and copyright information in PMC

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