Picramenos D, Deliveliotis C, Macrichoritis K, Alexopoulou K, Kostakopoulos A, Dimopoulos C
Service d'Urologie, Université d'Athènes, Grèce.
Prog Urol. 1995 Nov;5(5):701-5.
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.
我们报告了我们治疗福尼尔坏疽的经验。10例患有生殖器坏死性筋膜炎的男性患者接受了广泛的手术清创和广谱抗生素治疗。其中4例为酗酒者，6例为糖尿病患者。可能的病因包括3例直肠周围脓肿、2例尿道狭窄、2例外伤性尿道插管、1例附睾炎以及另1例疝气修补术。每位患者平均需要进行2.3次手术，平均住院时间为38.1天。其中3例接受了双侧睾丸切除术，2例进行了结肠造口术，4例插入了耻骨上导管。4例患者发生急性肾衰竭，3例出现成人呼吸窘迫综合征。3例患者死亡。4例患者需要使用皮瓣进行重建。我们得出结论，福尼尔坏疽是一种真正的泌尿外科急症，有潜在致命性，需要积极的抗生素和手术治疗。
