Fournier's gangrene: report of 51 cases. Diagnosis and therapeutical views.

Objective: To approach the treatement of Fournier's gangrene. So, pathophys iology and etiology are recallled. Methods: The authors present 51 cases of Fournier's gangrene treated from 1 989 to 1998, their age ranged from 19 to 89 years. Data were collected on a dmission signs and symptoms, physical examination. Aggressive surgical debr idement of all necrotic tissues was performed, Intravenous antibiotics and resuscitation fluid were also administered. Results: All patients were male. In 20 cases (39%), there was no identifiab le cause, and in 31 cases (61%), the etiology of gangrene was urethral (33% ), anorectal (28%) and unknown (19%). The average hospital stay was 30 days . Three cases underwent unilateral orchidectomy, six colostomy and in 17 ca ses, a suprapubic catheter was inserted. Mortality was high (18%) and essen tially associated to debilated state and toxi-infectious context. Conclusion: Fournier's gangrene is a true urolologic emergency potential le thal, wich requires aggressive antibiotic and surgical treatement. (C) 2001 Editions scientifiques et medicales Elsevier SAS.