Context:
Fournier's gangrene (FG) is a rapidly progressing acute gangrenous infection of the anorectal and urogenital area.
Aims:
The objectives of this study were to investigate patients with FG and to determine risk factors that affect mortality.
Settings and Design:
Retrospective clinical study.
Materials and Methods:
Clinical presentations and outcomes of surgical treatments were evaluated in 68 patients with FG.
Statistical Analysis Used:
Chi-square, Student's t -test, and logistic regression test.
Results:
Mean age of patients was 54 and female-to-male ratio was 9:59. Among the predisposing factors, diabetes mellitus (DM) was the most common (n =24, 35.3%), and sepsis on admission was detected in 31 (45.6%) and 15 (22.1%) patients, respectively. Seven (10.3%) patients died. Using logistic regression test, Fournier's Gangrene Severity Index (FGSI) <9, DM and sepsis on admission were found as prognostic factors. Conclusions: FG has a high mortality rate, especially in patients with DM and sepsis. An FGSI value <9 indicates high mortality rate.
In this study, pathological stage was found to be the most important factor affecting urethral recurrence and prostatic stromal invasion was an important prognostic factor in these cases. Although risk factors for urethral recurrence were similar in both groups, urethral recurrence rates were significantly lower in OCD group when compared to IC group.
In this study, we found that "W" ileal neobladder reconstruction offers similar storage and voiding functions to normal bladder. Urodynamic evaluation of the "W" neobladder revealed similar results to that of a normal bladder. We conclude that "W" ileal neobladder construction results in a near-normal-functioning orthotopic reservoir that can be safely offered to patients.
Aim : The assumed necessity of antimicrobial prophylaxis prior to cystoscopy is controversial. In this study, the rate of bacteriuria, pyuria and bacteremia in outpatients who underwent cystoscopy without antimicrobial prophylaxis is investigated prospectively. Methods : The study included 75 patients who underwent cystoscopy for various indications and had sterile urine prior to intervention. A clean midstream urine sample was obtained 24 h before and 48 h after the procedure. Blood cultures were taken 1 h after cystoscopy. Patients were questioned for newly developed symptoms 48 h after cystoscopy. Blood cultures were taken again from patients who presented with fever. Results : Six patients (8%) developed significant bacteriuria, and six patients (8%) developed pyuria without significant bacteriuria. Bacteremia was not determined in any of the patients. The association between presence of pyuria prior to the procedure and development of bacteriuria after the procedure was significant ( P < 0.05). Four patients out of six who had bacteriuria were asymptomatic. In our study we found significant bacteriuria after cystoscopy in 8% of patients, and no bacteremia. Conclusions : Thus we conclude that cystoscopy is a safe and well-tolerated procedure. Antimicrobial prophylaxis should not be administrated unless specific indications are present.
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