A Case of a Penile Necrosis in a Patient with Simultaneous Fournier’s Gangrene and Priapism

Abstract

Fournier's gangrene (FG) is a necrotizing fasciitis of the perineal and genital areas, characterized by severe complications and a high mortality rate. The occurrence of concurrent priapism is extremely rare and carries a very poor prognosis. We report the case of a 74-year-old male patient with no medical history who presented with FG of the scrotum and penis associated with simultaneous priapism. He received intravenous antibiotic therapy, cavernous aspiration, and surgical debridement. In the following days, the penis became completely necrotic. A total penectomy was performed with a perineal urethrostomy following complete wound closure. There are only a few documented cases in the medical literature of simultaneous Fournier's gangrene and priapism. Consequently, there is no established protocol for managing this rare occurrence. When gangrene extends to the penis, cavernous aspiration is not recommended as it tends to exacerbate penile necrosis in the majority of cases. However, early administration of broad-spectrum antibiotic therapy, surgical debridement, and urinary diversion are necessary to prevent necrosis and sepsis.