Objectives: To evaluate the etiologic factors and the effects of surgical debridement and adjunctive therapies on morbidity and mortality of Fournier’s gangrene. Methods: 27 males, 1 female, a total of 28 patients with a mean age of 58 years treated for Fournier’s gangrene were evaluated retrospectively. Results: Predisposing factors including diabetes, alcohol abuse, paraplegia and renal insufficiency were identifiable in 54% of the patients. Etiologic origin of the gangrene was urogenital, cutaneous and anorectal in 43, 25 and 11% of the patients, respectively. The pathology was limited to genitalia in 10, extending to perineum in 8, the umbilicus in 7 and even up to the axilla in 3 patients. Suprapubic cystostomy and colostomy were necessary in 18 and 2 cases, respectively. We used hyperbaric oxygen therapy in 2 and honey in 6 patients to accelerate wound healing. A repeat debridement was necessary in 39% of the cases. Plastic surgery and grafting were done in 14 patients. Our mortality rate was 7%. Conclusion: Early recognition of the pathology and aggressive surgical debridement are the mainstay of the management of Fournier’s gangrene. Additional strategies to improve wound healing and increase patient survival are also needed.
Objective To compare the efficacy of standard transurethral electroresection of the prostate (TURP) and visual laser ablation in the treatment of benign prostatic hyperplasia (BPH).
Patients and methods In a randomized prospective study, the prostate glands of 60 patients with symptomatic bladder outlet obstruction caused by BPH were treated with TURP or visual ablation with the Ultraline side‐firing Nd:YAG laser; the patients were assessed using standard symptom scores, the measurement of residual urine and uroflowmetry both before and at 3 and 6 months after treatment.
Results All patients in both treatment groups had a significant improvement in symptoms and objective measures of voiding. The laser treatment gave significantly better improvements in symptom score than did TURP (P=0.034), but TURP produced significantly better peak urinary flow rates (P=0.025).
Conclusion These early results indicate that laser ablation of BPH may be a good alternative in the surgical treatment of this disease.
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