Isolated Penile Fournier’s gangrene: A case report and literature review

Abstract

Highlights Penile Fournier’s gangrene is very rare clinical entity, which is also known wet gangrene of the penis. Penile Fournier’s gangrene is reported in only few reports in the literature. Fournier’s gangrene is usually managed using a multimodal approach. Early and aggressive surgical debridement is the standard initial treatment. Penile reconstruction, using scrotal flap or skin graft results in satisfactory functional and cosmetic outcomes.

Isolated Penile Fournier's Gangrene: A Rare Case

“…The underlying causes are mostly idiopathic. Penile trauma and urethral stricture were suspected in two cases [3]. Penile injection of cocaine and human bite were reported in another study [4][5].…”

“…Panurethral necrosis was rarely reported. Long-term urethral catheterization of an immunocompromised patient was considered a risk factor in the reported cases [1][2][3][4][5][6].…”

<p>Fournier Gangrene in the Emergency Department: Diagnostic Dilemmas, Treatments and Current Perspectives</p>

“…3 Additional risk factors include recent trauma or surgery and use of injection drugs such as cocaine or heroin, particularly if patients inject directly into inguinal veins, penile veins, or cavernosa. 17,18 Use of sodium-glucose cotransporter 2 inhibitors (SGLT2i)antihyperglycemics that augment urinary glucose excretion -have been related with FG in multiple case reports, submit your manuscript | www.dovepress.com…”

“… 3 Additional risk factors include recent trauma or surgery and use of injection drugs such as cocaine or heroin, particularly if patients inject directly into inguinal veins, penile veins, or cavernosa. 17 , 18 Use of sodium-glucose cotransporter 2 inhibitors (SGLT2i)—antihyperglycemics that augment urinary glucose excretion—have been related with FG in multiple case reports, resulting in a warning from the US Food and Drug Administration in 2018 for patients to seek attention if experiencing symptoms of genital discomfort, erythema, and fever while taking an SGLT2i. 19 However, this link remains unclear as the risk of FG is already significantly higher in patients with diabetes, and large-scale analyses comparing SGLT2i to other antihyperglycemics have found no increased risk of developing FG.…”

“… 12 , 59 Abrasions and fluctuance of the genitalia and perineum should raise suspicion for FG. 17 Skin changes including crepitation upon palpation of affected tissues, bronzing, purpura, bulla formation, and patchy anthracosis indicate disease progression. 53 Presence of crepitus and subcutaneous gas is highly specific for gas-forming organisms, most often clostridial infections.…”