A three-year review of the management of Fournier's gangrene presented in a single Saudi Arabian institute.
BACKGROUND
Fournier's gangrene (FG), is a rare life threatening urologic emergency that requires immediate admission of metabolic stabilization and surgical debridement. The mortality rate ranges from 16% to 40%. This study was conducted to investigate the reasons behind the excellent survival rate in our center.


METHODS
A retrospective analysis of the medical records of 20 FG cases from January 2010 to January 2013 was conducted. Data was collected on patients' comorbidity, survivals, Fournier's severity index (FSI) at presentation, length of hospital stay (LOS), the number of intensive care unit (ICU) and operating room (OR) entries, the total phalli and testes removed, colostomies created, and cystostomies performed.


RESULTS
All 20 cases (100%) collected for the study survived. All patients were male. The median age of the patients was 55.95 years (39-78 year). Only one patient (5%) was admitted to ICU post-operatively. Penile amputation was carried out in three of the 20 cases (15%). The total number of OR entries was 34 (average of 1.7). A majority of 12 patients (60%) were diabetic. A total of six testes were extirpated from the study group. None of the patients required colostomy creation. Only one patient (5%) required a cystostomy tube insertion. FSI was 5.65 ranging from 0 to 14. The average length of hospital stay was 22.3 days.


CONCLUSIONS
In contrast to what is published in the literature, FG is not rare in our center. Perfect survival rate owes to the moderate severity of the cases treated, but mostly to the urgent surgical intervention with extensive debridement.
Department of Urology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
Atif
A
Katib
Department of Urology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
Mohammad
M
Al-Adawi
Department of Urology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
Bassem
B
Dakkak
Department of Urology, King Abdul-Aziz Hospital, Makkah, Saudi Arabia.
Amani
A
Bakhsh
FSI; Fournier's gangrene; debridement; necrotizing fasciitis; urologic emer; urologic emergency