[Perineo-scrotal gangrene. Analysis of 49 cases].

Perineo-scrotal gangrene is a necrotizing infection of the tissues of the perineum and scrotum. It accounts for 0.6% of our hospitalizations. The commonest etiology is urologic (86% of our cases). A proctologic origin was found in 6%, while the condition appeared to be primary in 8%. Concomitant diseases were found in 37% with diabetes the commonest. The diagnosis is clinically evident. The majority of patients are seen late (5 to 10 days) and the necrotizing process spreads rapidly. This is a multidisciplinary emergency, requiring intensive care, antibiotics, surgical excision of all necrotic tissues and possible urinary and/or fecal diversion. Extensive skin loss requires surgical cutaneous reconstruction procedures. The prognosis is severe, with a 12% mortality rate in our series.