Phalloplasty Following Penectomy for Fournier's Gangrene at a Tertiary Care Center

Abstract

Treatment of Fournier's gangrene often requires extensive surgical debridements that can ultimately necessitate penile amputation. Reconstruction can be challenging as these patients tend to have medical comorbidities deeming them poor microsurgical candidates. Fournier's gangrene resulting in penectomy is an infrequent occurrence, and treatment with phalloplasty is rarely described in the literature. Herein, we present a case of a 60-year-old male with poorly controlled diabetes mellitus who developed Fournier's gangrene in July 2017. His treatment course included multiple surgical debridements without resolution, eventually necessitating a penectomy. The patient elected for surgical reconstruction and underwent a phalloplasty procedure utilizing a radial forearm free flap. This case demonstrates a rare case of Fournier's gangrene resulting in penectomy with a unique reconstruction utilizing a radial forearm free flap in a poor microsurgical candidate.

Keywords: dermal regeneration template; fournier’s gangrene; free flap; penectomy; phalloplasty; reconstruction.

Figure 1. Preoperative view of a patient after penectomy with a Foley catheter in native urethra and a suprapubic catheter

Figure 2. Postoperative view of patient after phalloplasty at two weeks (left) and at two months (right)