Background: Fournier's gangrene (FG) is a fulminant aggressive necrotizing fascitis affecting the external genitalia, perineum and anterior abdominal wall with significant mortality rate. The aim of the present study was to describe the associated risk factors, presentation, diagnosis, management and outcome of this condition in Benghazi, Libya. PATIENTS & METHODS: Over a period of twenty years (from January 1997 to October 2016) a series of 54 consecutive patients who were admitted to Urology Department, Hawari Center for Urology and Otolaryngology, Benghazi-Libya were evaluated retrospectively to assess the risk factors, etiology, management and outcome of this fatal disease. Results: It was found that 37 (68.5%) of patients were diabetics and 24 patients (44.4%) had perianal abscess as predisposing factor. Mortality rate was 14.8% (8 patients). All cases diagnosed on clinical basis. The patients operated promptly by extensive debridement. Reconstructive surgery done by flap or graft in plastic department to close the skin defect in most of our patients (41 patients, 75.9%). Conclusion: The main co-morbidity and predisposing factors of FG are diabetes mellitus and perianal abscess respectively. Prompt aggressive debridement is the only management to save the patient's life.

Background and Aim: Penile fracture is a relatively rare urological emergency. The aim of this study was to review the experience with 69 consecutive cases in Benghazi, Libya. Patients and Methods: Records of 69 penile fracture cases who presented between January 1997 and December 2018 to Hawari Center for Urology, Benghazi, Libya were retrospectively reviewed. Penile fracture diagnosis was based on classic history and typical physical signs. Surgical exploration was performed for all patients under spinal anesthesia. Results: The most common mechanism of penile fracture was self-inflicted forceful bending (manipulation) of erected penis which account for 39 (56.5%) patients, followed by vigorous sexual intercourse in 19 (27.5%) patients, masturbation in five (7.2%) patients, rolling over an erect penis in bed in five (7.2%) patients, and slipping in WC in one (1.5%) patient. Clinical features at presentation include intense pain in 97%, sudden audible popping sound in 87%, rapid de tumescence in 94.2%, followed by development of swelling and ecchymosis in all patients (100%). All patients were treated surgically and no intraoperative or immediate postoperative complications were encountered. During the follow-up period, all patients had normal urinary steam and normal sexual function was experienced by 97.1% of the patients. Five patients (7.2%) had long-term complications: penile hypoesthesia (one patient), painful erection (one patient), penile curvature of <15o on erection (one patient), and mild erectile dysfunction (two patients). Most patients were discharged home on postoperative day 1. Conclusion: Penile fracture occurred mainly due to forceful sexual manipulation of erected penis, and diagnosis can be made clinically. Immediate surgical repair is the only option to avoid complications.