[Fournier's gangrene: etiology, treatment, and complications]

We report our experience in the treatment of Fournier's gangrene. Ten male patients suffering from necrotising fasciitis of the genitalia were treated by extensive surgical debridement and broad spectrum antibiotic administration. Four were alcoholic and six diabetic. The possible cause was perirectal abscess in 3 cases, urethral stricture in two, traumatic urethral catheter insertion in two, epidydimo-orchitis in one and finally herniorraphy in another case. An average of 2.3 operations was required per patient and the average hospital stay was 38.1 days. Three of them underwent bilateral orchidectomy, two colostomy and a suprapubic catheter was inserted in four cases. Four patients developed acute renal failure and three adult respiratory distress syndrome. Three patients died. Reconstruction using skin flaps was necessary in 4 patients. We conclude that Fournier's gangrene is a true urologic emergency, potential lethal, which requires aggressive antibiotic and surgical treatment.