PTU - Polskie Towarzystwo Urologiczne
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Fournier\'s gangrene - analysis of 13 cases
Article published in Urologia Polska 2001/54/4.


Adam Gołąb 1, Jan Sprogis 1, Alina Kaczmarek 2, Andrzej Sikorski 1
1 Katedra i Klinika Urologii Pomorskiej Akademii Medycznej, Szczecin
Kierownik kliniki: prof, dr hab. Andrzej Sikorski
2 Katedra i Zakład Mikrobiologii i Immunologii Pomorskiej Akademii Medycznej, Szczecin
Kierownik katedry: prof, dr hab. Stefania Giedrys-Kalemba


genito-urinary tract, Fournier\'s gangrene


ntroduction: Fournier\'s gangrene (FG) is a rapidly progressing necrosis of the genitals, perineum or the abdominal wall. FG is a serious therapeutic problem. We report our experience with the management 13 patients with this pathologic entity.
Methods: Thirteen patients (ean age 58 years) with FG were treated from 1997 to 2000. Eight patients were diabetic and one manifested chronic alcoholism. Lesion were limited to the scrotum in most cases. Cultures showed mixed aerobic and anaerobic microorganisms. Broad-spectrum antimicrobial therapy and aggressive surgical debridement were performed to control the infection. One patient received hyperbaric oxygen.
Results: All patients underwent incision of the fascias of the perineum, resection of the necrotic areas and drainage. In 7 cases performed orchiectomy unilateral or bilateral, 3 - suprapubic catheter was inserted. One patient with broad gangrene underwent laparotomy, also one patient required amputation right thigh due to thrombotic complications. Free skin graft were harvested from the ventral aspect of the thigh and applied to one patient. Three patients died. Hospitalization averaged 30 days.
Conclusions: FG is a urologie emergency that requires prompt recognition, aggressive treatment with parenteral antibiotics, surgical debridement and hemodynamic stabilization. Despite optimal management the mortality rate in FG still remains high.


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