Mustafa KORKUT, Özlem İLBEY, Aykut KEFİ, Bülent SEMERCİ, Barış ALTAY

Fournier's gangrene: Report of twenty-three cases and review of the literature

ISSN: 1017-7698
Yayın Aralığı: 3
Başlangıç: 2018
Yayıncı: Ege Üniv. Tıp Fak.

Fournier's gangrene, a form of necrotizing fasciitis, is fulminant, rapidly progressing subcutaneus infection of the ano-rectal, perineal, and penoscrotal regions, and may occur in all age groups. The aim of the present study is to evaluate the etiology, pathogenesis and current treatment protocols of this uncommon condition on the basis of patient series and review of the literature. We reviewed the records of 23 cases of Fournier's gangrene who had been diagnosed and treated in the Urology Department of Ege University of Faculty of Medicine from 1988 to 2000. All patients except two were males and the patients were between 17 to 77 years old ( 57.5 $pm$7.8). Twelve had a history of alcoholism and seven had diabetes, The possible cause was perirectal abscess In twelve cases, anal fistula in three patients, urethral dilatation in one patient, traumatic urethral catheter insertion also in one patient and scrotal furuncle in two patients. The underlying condition was unknown in the remaining four patients, The management included aggressive surgical debridement of necrotic tissue with incisions, broad spectrum antibiotic therapy, hyperalimentation and plastic reconstructive surgery Twelve of them underwent colostomy, one of them underwent bilateral orchiectomy, and a suprapubic catheter was used in ten patients, In one patient, full thickness skin graft was used for resonstruction. Nine-teen patients survived and four of them died after Fournier's disease. We conclude that Fournier's gangrene is a true urologic emergency with high mortality, and requires early diagnosis with prompt surgical debridement and antibiotic therapy