Fournier gangrene is a severe infection of the penis and surrounding areas. It is an example of a necrotizing infection, one where the skin and underlying tissue start to die, and is considered a medical emergency. Within 72 hours of the development of the initial symptoms of redness and pain, the patient can die if treatment is not provided. Treatments include medications to address the infection, along with surgery to remove dead tissue.
The cause of Fournier gangrene is usually an underlying infection, such as a urinary tract infection. People with compromised immune systems and existing chronic diseases like diabetes are more likely to develop Fournier gangrene. The early warnings signs include redness and pain in the groin, along with swelling. The patient may also experience a sensation of tightness, caused by skin stretching as the tissues in the genitals start to swell.
If the Fournier gangrene is allowed to progress, the infected tissue will start to die. Red, weeping sores will appear along with areas of darkness and discoloration. The infection can enter the bloodstream, leading to systemic bacterial infection. This can fatal if not treated, and the onset of such infections can be extremely rapid. Once the infection enters the bloodstream, it becomes much more challenging to treat.
A urologist is usually in charge of care for Fournier gangrene. Treatment starts with aggressive broad spectrum antibiotics to arrest the infection in its tracks, and the patient will need surgery to remove dead and infected tissue. If this tissue is left in place, the infection can continue to rage, damaging the genitals and potentially spreading to other parts of the body. In surgery, the doctor will remove as much unhealthy tissue as possible. This can change the shape and appearance of the genitals, leading to the need for reconstructive surgery after the patient has recovered.
Patients may be initially shy about seeking treatment for conditions involving the genitals out of shame or worry about being admonished. With Fournier gangrene, it is urgent for a doctor to see the patient as soon as the symptoms start appearing. The earlier a doctor can diagnose the condition and start treatment, the better the outcome for the patient. Early intervention can preserve more of the genitals, in addition to reducing the risk of developing serious complications. Urologists have seen it all and they are more focused on providing immediate patient care than scolding patients.