Fournier's Gangrene in Females: Presentation and Management at a Tertiary Center

• Published in: Urology (Ridgewood, N.J.) N.J.), 2021-05, Vol.151, p.113-117
• Main Authors: Beecroft, Nicholas J., Jaeger, Christopher D., Rose, Justin R., Becerra, Clara M. Castillejo, Shah, Nayan C., Palettas, Marilly S., Lehman, Amy, Posid, Tasha, Jenkins, Lawrence C., Baradaran, Nima
• Format: Article
• Language: English
• Subjects: Body Mass Index; Buttocks - pathology; Buttocks - surgery; Debridement; Female; Fournier Gangrene - microbiology; Fournier Gangrene - mortality; Fournier Gangrene - surgery; Humans; Male; Middle Aged; Perineum - pathology; Perineum - surgery; Retrospective Studies; Tertiary Care Centers; Vulva - pathology; Vulva - surgery
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2020.05.056

To report and compare presentation and management of Fournier's Gangrene (FG) in female vs male patients at a single tertiary care center. Patient demographics, clinical characteristics, treatments and outcomes were summarized and compared between males and females who were treated for FG from 2011 to 2018 at a single institution. Of the 143 patients treated for FG at our institution, 33 (23%) were female. Female patients were predominantly white (82%), with a median (IQR) age of 55 (46, 59). Median female boby mass index (BMI) was 42.1 (32, 50.4). Female patients’ wound cultures were polymicrobial mix of gram positive and gram negative organisms. Median number of debridements for females was 2 (1,3). The most common anatomic region of gangrene involvement in females was labia (76%) followed by perineum (55%) and gluteus/buttocks (42%). Mortality rate during initial admission was 6% for females. Female patients had a higher median BMI than males (42.1 vs 33.7 respectively; P = .003). FG severity index, length of hospital stay, number of debridements, and wound cultures were comparable to males. The surgical team managing initial debridements differed with females managed primarily by general surgery and males primarily by urology. Mortality rate was comparable to men (6% vs 7%, P >.05). Female patients with FG have greater BMI but similar clinical presentation, microbiologic characteristics and mortality rate compared to men. Urologists have little involvement during initial management for females at our institution.