External Genitalia Gangrene: Clinical, Therapeutic Aspects and Prognosis at University Hospital Souro Sanou of Bobo Dioulasso (Burkina Faso)
- 1 Department of Urology, Sanon Souro Teaching Hospital, Bobo Dioulasso, Burkina Faso
- 2 Department of Urology, Sanon Souro Teaching Hospital, Bobo Dioulasso, Burkina Faso
- 3 Department of Urology, Sanon Souro Teaching Hospital, Bobo Dioulasso, Burkina Faso
- 4 Department of Urology, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso
- 5 Department of Urology, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso
- 6 Department of Surgery, Division of Urology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
- 7 Department of Urology, Sanon Souro Teaching Hospital, Bobo Dioulasso, Burkina Faso
Abstract
Objective: To describe the clinical aspects and the management of external genitalia gangrene in the Urology department of the Bobo Dioulasso CHUSS. Patients and methods: This was a retrospective and descriptive study over a period of 6 years from January 2011 to December 2016, which covered 54 patients hospitalized in the urology department of the University Hospital Souro Sanou for external genitalia gangrene. Results: The mean age of our patients was 53.8 years. The large ulcero-necrosis of scrotum was the main reason for reference. Our patients consulted on average 8.23 days after the onset of symptomatology. A risk factor was found in 44.2% of cases and a cause was identified in 65.3% of patients. A urogenital cause was present in 32.7%. Probabilistic antibiotic therapy and medical reanimation were systematic at admission. Debridement was performed on average 18 hours after admission and 10 patients had more than one debridement. We noted a mortality rate of 5.5%. Conclusion: Fournier’s gangrene is a serious infectious disease whose diagnosis is often delayed in our context. Early surgical debridement remains the essential therapeutic gesture to reduce mortality.
- Sarkis, P., Farran, F., Khoury, R., Kamel, G., Nemr, E., Bianjini, J. and Merheje, S. (2009) Gangrène de Fournier: revue de la littérature récente. Progrès en Urologie, 19, 75-84. https://doi.org/10.1016/j.purol.2008.09.050
- Marynowski, M.T. and Aronson, A.A. (2008) Fournier’s Gangrene Medicine. http://emedicine.medscape.com/article/2028899-overview
- Rimtebaye, K., Niang L., Ndoye, M., Traore, I., Vadandi, V., Gueye, S.M. and Noar, T. (2014) Gangrène de Fournier: aspects épidémiologique, clinique, diagnostique et thérapeutique au service d’Urologie de N’djaména. Uro’andro, 1, 91-98.
- Clayton, M.D., Fowler, J.E., Sharifi, R. and Pearl, R.K. (1990) Causes, Presentation and Survival of Fifty-Seven Patients with Necrotizing Fascitis of the Male Genitalia. Surgery, Gynecology & Obstetrics, 170, 49-55.
- Fall, B., Fall, A.A., Diao, B., Kpatcha, M.T., Sow, Y., Kaboré, F.A., Ali, M., Ndoye, A.K., Ba, M. and Diagne, B.A. (2009) Les gangrènes des organes génitaux externes dans le service d’urologie-andrologie, CHU Aristide-Le-Dantec: à propos de 102 cas. Andrologie, 19, 45-49.
- Fakhfakh, H., Chabchoub, K., Slimen, M.H., Bahloul, A. and Mhiri, M.N. (2006) La gangrène des organes génitaux externes de l’homme: Facteurs de risque et pronostic. Andrologie, 16, 229-234.
- Nambiar, P.K., Lander, S. and Midha, M. (2005) Fournier Gangrene in Spinal Cord Injury: A Case Report. Journal of Spinal Cord Medicine, 28, 121-124. https://doi.org/10.1080/10790268.2005.11753809
- Hubert, J., Fournier, G., Mangin, P. and Punga-Maole, M. (1995). Gangrène des organes génitaux externes. Progrès en Urologie, 5, 911-924.
- Borki, K., Ait Ali, A., Choho, A., Daali, M., Alkandry, S. and André, J.L. (2002) La gangrène périnéo-scrotale: à propos de 60 cas. E-mémoires de l’Académie Nationale de Chirurgie, 1, 49-54.
- Mejean, A., Codet, Y.P., Vogt, B., Cazalaa, J.B., Chrétien, Y. and Dufour, B. (1999) Gangrène de Fournier étendue à la totalité du scrotum: Traitement par excisions chirurgicales itératives multiples, colostomie de dérivation, triple antibiothérapie et réanimation post-opératoire. Progrès en Urologie, 9, 721-726.
- Smith, G.L., Bunker, C.B. and Dinneen, M.D. (1998) Fournier’s Gangrene. British Journal of Urology, 81, 347-355. https://doi.org/10.1046/j.1464-410x.1998.00532.x
- Schaeffer, E.M. and Schaeffer, A.J. (2007) Infections of the Urinary Tract. In: Wein, A., Ed., Campbell-Walsh Urology, Saunders Elsevier, Philadelphia, PA, 301-303.