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Fournier’s Gangrene, a Urologic and Surgical Emergency: Presentation of a Multi-Institutional Experience with 45 Cases

2011; Karger Publishers; Volume: 86; Issue: 2 Linguagem: Inglês

10.1159/000321691

1423-0399

Dimitrios Koukouras, Panagiotis Kallidonis, Constantinos Panagopoulos, Abhulrahman Al-Aown, Anastasios Athanasopoulos, Christos Rigopoulos, Eleftherios Fokaefs, Jens‐Uwe Stolzenburg, Petros Perimenis, Evangelos Liatsikos,

Pelvic floor disorders treatments

Objective: To review multi-institutional, multidisciplinary experience in the management of Fournier’s gangrene (FG) in an attempt to identify etiologic parameters as well as to propose methods of efficient management. Patients and Methods: Retrospective chart review of 45 patients diagnosed with FG and treated in three departments (general surgery and urology departments) was performed. Results: Average patient age was 50 ± 15.8 (range 33–81) years. Five female and 40 male patients. Seven patients deceased due to the disease. In 26 and 6 cases, perianal or ischiorectal abscess was present, respectively. These abscesses were extending up to the level of rectovesical/Douglas pouch in 12 cases. Abscesses in the scrotum and perineum were revealed in 10 and 6 cases, respectively. A fistula to the rectum and 8 sinuses to the skin were observed. Colostomy was performed in 25 cases, diverting cystostomy in 17, and orchidectomy in 12 cases. In 18 patients (40%) repeat debridement was deemed necessary. Three patients required more than 3 debridement procedures. Average hospitalization time was 15.7 ± 11.6 (range 4–40) days. Conclusion: FG is a life-threatening form of necrotizing soft tissue infection. The disease is unpredictable and the currently proposed methods for prognosis are promising but still questionable.