The aetiology, clinical syndrome and outcome of nine patients with necrotising subcutaneous infections of their external genitalia have been analysed. These patients constituted just under 1% of all of our urological admissions during a nine-month period. Eight of the nine patients suffered from the secondary variety of this disease with urethral strictures and extravasation being the most common precipitating conditions. Necrotising fasciitis of the genitalia still carries a high risk of mortality and morbidity, frequently necessitating long periods of hospitalisation and repeated surgical procedures. Special attention was given to the bacteriology of the disease and recommendations concerning antibiotic therapy are made.

A brownish discoloration of the bladder mucosa on cystoscopy and the histological findings in a bladder biopsy specimen of submucosal vascular basement membrane thickening, pigment or chronic inflammatory changes in the absence of infection were present in various combinations in all our patients with analgesic-associated nephropathy. None of these findings was present in a control group of patients with other established causes of renal function impairment. More objective diagnostic aids may lead to a greater awareness and earlier diagnosis of this preventable cause of chronic renal failure.