Management of a challenging open urethral defect in a patient with Fournier's gangrene: A case report

Fournier's gangrene is a rare but life-threatening disease that affects the genitals and perineum, and requires surgical intervention. Open Urethral defect as a complication of Fournier's gangrene is rarely reported [1]. It poses a significant challenge for management, requiring a multidisciplinary approach due to its complexity and poor healing potential.

We report a case of open urethral defect secondary to Fournier's gangrene in a 54-year-old male patient with poorly controlled diabetes. The patient was managed jointly with plastic and urologic surgery teams. The defect was repaired, and the repair site was covered with a penile fasciocutaneous flap. The remaining wound was covered with a split-thickness skin graft. The reconstruction was successful, but the aesthetic outcome was suboptimal.

Open urethral defects complicating Fournier's gangrene represent a rare clinical entity with limited literature to guide management. The complex anatomy of perineogenital region and paucity of reliable reconstructive options pose significant surgical challenges. The innovative application of penile fasciocutaneous flap for urethral reconstruction combined with multidisciplinary approach, is crucial for successful outcomes in these complex defects.

Management of an open urethral defect in Fournier's gangrene is challenging requiring critical analysis of availability of reconstructive options which may be limited. There is a need for innovative surgical technique and multidisciplinary approach to improve functional and aesthetic outcomes of such patients.