Gangrene of the External Genitalia: Vital and Functional Prognosis in the Urology Department of the Cocody University Hospital from 2010 to 2022

Abstract

Intr oduction : The aim of our study was to identify the factors that determine the vital and functional prognosis of patients with gangrene of the external genitalia. Patients and Methods: Our study is retrospective and descriptive. It concerned all patients treated for GOGE in the Urology Department of the Cocody University Hospital over a period of 13 years. Results: Among the 3244 patients consulted for a surgical pathology, 73 (2.25%) had a GOGE. The mean age of patients was 48.81 years, with extremes of 19 and 74 years. The majority of patients were male. The main reasons for consultation were scrotal swelling (41.1%) and perineal pain. More than half (53.1%) consulted between 8 and 15 days. Gangrene mainly affected the scrotum, perineum, and in some cases, the penis and pelvis. Diabetes was the most common risk factor (50.68%), followed by alcoholism (23.29%) and acute kidney injury (15.07%). Urological causes were the most common, with more than half of the cases (61.64%). All patients underwent surgical debridement. Triple broad-spectrum antibiotic therapy combining a 3rd generation cephalosporin, an Imidazole and an Aminoside was initiated in the majority of cases (93.15%). Nearly half of the patients were treated the day after their admission. The cure rate was 89.04%, with a mortality rate of 6.85%. Major erectile dysfunction and dysuria were found in 35.61% and 34.25% of patients, respectively. Conclusion: Early therapeutic management, well-codified treatment and a multidisciplinary care pathway could improve patients’ prognostic factors. Our study suggests that patients surviving after gangrene of the external genitalia show a marked and continuous impairment in their overall urological and sexual quality of life.