Fournier’s Gangrene of the genitals is an extremely rare condition that happens in the body when an infection is present in the body near the genitals or there are circumstances that make your body vulnerable to spreading disease and infection, like chemotherapy and heavy medication treatments. When people hear the word ‘gangrene,’ they often think of the feet and toes being affected. Sometimes from hypothermia and other times from infection. With Fournier’s Gangrene, the genitals and tissues around the body are affected and it is not caused by hypothermia.
Gangrene occurs when there is tissue on the body that is dead or dying, or necrosis, due to the lack of blood flow to the area or a bacterial infection. Fournier’s gangrene involves an infection that is in the scrotum, penis, or perineum. The perineum is an area of tissue located between the anus and scrotum of a man, and the anus and vulva for a woman. For people with this rare condition, the tissue from the surrounding areas of the thighs, stomach and even chest can be affected.
Fournier’s gangrene in the genitals is extremely rare. Men are more likely to contract this disease, although women and children are also susceptible. This disease affects most males between the ages of fifty and sixty years old. Men are ten times more likely to end up with Fournier’s gangrene than women, and it is even more rare in children.
What are the causes for Fournier’s gangrene in the genitals?
Fournier’s gangrene is most often caused by an infection somewhere in the body. The most common reasons for infections leading to this disease are:
-Abscesses or swollen body tissue that contains pus throughout the body.
-Hysterectomies
-Bladder infections and urinary tract infections
-Autoimmune conditions where your immune system is weakened for any amount of time.
-Chemotherapy
-Insect Bites
-Burns
-Circumcision
-Diabetes
-Diabetes medications prescribed to treat the blood disorder have been directly linked to developing this condition. The FDA has links and studies with proven facts on how certain medications can cause these issues.
-Alcohol abuse and over-use
-Steroids
-Trauma to the genital area
-HIV or AIDS
-Cirrhosis of the liver or liver disease
-Obesity
In cases where Fournier’s gangrene is diagnosed, doctors are usually able to find the root cause for over ninety percent of cases (ACS).
These are the listed diabetic medications prescribed and now marked by the FDA as possible causes for Fournier’s gangrene of the genitals (empr.com):
Canagliflozin or Invokana
canagliflozin and metformin or Invokamet or Invokamet XR
dapagliflozin or Farxiga
dapagliflozin and metformin extended release or Xigudo XR
dapagliflozin and saxagliptin or Qtern
empagliflozin or Jardiance
empagliflozin and linagliptin or Glyxambi
empagliflozin and metformin or Synjardy or Synjardy XR
ertugliflozin or Steglatro
ertugliflozin and metformin or Segluromet
ertugliflozin and sitagliptin or Stegujan
The FDA now requires warning labels on these medications for their chance to cause and increase the risk factors for people to develop Fournier’s gangrene of the genitals. These are SGLT2 inhibitors, and all health care professionals should be persistent with regular checkups and testing to ensure there are no signs of any developing infections while on these medications.
What are the symptoms of Fournier’s gangrene of the genitals?
If you suspect that you have Fournier’s gangrene, you might experience some of these symptoms:
-Pain and swelling in and around the genitals and anal area.
-Fever that does or does not lower with fever reducing medications.
-Unpleasant or unusual odor coming from the affected skin and tissue.
-Cracking or crackling sounds coming from the affected area of skin when touched.
-Dehydration and extreme thirst.
-Anemia which is low iron in the blood; this can be harder to identify without blood tests.
How is Fournier’s gangrene of the genitals treated?
There are two main types of treatment for Fournier’s gangrene. Strong IV antibiotics and the surgical removal of the dead and dying tissues from the area until clear margins are discovered are the best tools for this disease.
There is a chance that after your surgery you may need further treatment to keep your infection under control. Some end up with colostomies for ridding the body of fecal matter or catheters for removing urine from the body. Sometimes hyperbaric oxygen therapy is recommended for healing. This type of therapy places a person in a chamber of room with pure oxygen allowing the cells in the body to absorb all the good it needs, and then the room is “surfaced” similar to a submarine and the pressures within. This is a very helpful and unique process being used more and more in the medical world.
Is there any way to prevent getting Fournier’s gangrene? Or at least lower my risk?
There are some steps that you can take to reduce your risk and chances of getting Fournier’s gangrene of the genitals. Here are some of the most common tips:
-To lower your risk of wound infection, wash and dry any open wounds regularly with soap and water until they heal, or if your doctor has prescribed.
-If you are a smoker or tobacco chewer, stop now! Tobacco use causes damage to blood cells in the body, which can weaken them and lead to more infections.
-If you have diabetes, be sure to check your genitals and entire body regularly for signs of wounds or infection, swelling and any sort of tissue damage.
-If you are obese or overweight, try to lose some weight to relieve the tightness and pressure in stretched skin.
What is the expected outcome of Fournier’s gangrene in the genitals?
Many hospitals report that less than 0.02 percent of all hospital admissions across the United States are due to Fournier’s gangrene. Aside from the low chances of getting this disease, those that do face a twenty to forty percent chance of death due to the untreated condition and complications from the dead and decaying tissue. In other countries than the United States, this rate is even higher. As a rule, the older than person is that is diagnosed with Fournier’s gangrene the more general health problems they have, and more side effects they will face form this disease.
If you suspect you have Fournier’s gangrene of the genitals, do not wait to get help immediately. Getting the proper help in a timely manner can prevent you from having the infection spread beyond a manageable area.
Citations:
ACS
Medical News Today
FDA