Fournier’s Gangrene Post Circumcision in a Tertiary Hospital in Southern Nigeria

Abstract

Purpose: Fournier’s gangrene is a rapidly progressing necrotizing fasciitis. It is a true urological emergency. It is a relatively rare condition. The aim was to highlight the presentation and management of Fournier’s gangrene following circumcision. Methodology: This was a retrospective study. Eight patients who presented with features of Fournier’s gangrene post circumcision between January 2012 and December 2021 to University of Port Harcourt Teaching Hospital UPTH were included in the study. A questionnaire was used to obtain data from all patients listed in the medical records department as having been treated for Fournier’s gangrene during the study period. Data collected include age at presentation, level of education of mother, duration of symptoms before presentation, who carried out the circumcision, where the circumcision was carried out, number of debridement carried out and complications. The data was entered using Microsoft Excel 2016 version and transferred into the statistical package for social sciences (SPSS) for windows (version 20) (IBM SPSS Inc. Chicago, IL) for analysis. Categorical data was presented in the form of frequencies and percentages using tables. Continuous variables were presented in means and standard deviation. Results were presented in tables and charts. Findings: A total of eight patients had FG following circumcision. The median age was 14days and range was from 10 days to 10years. The parents of most patients (87.5%) presented with no formal education or primary level of education. Most patients (62.5%) presented 4 to 6 days after onset of symptoms. Five out of 8 had their circumcision by a traditional attendant. Three patients had complications. One patient died. Circumcision can be a predisposing factor to FG especially if it is carried out at home, and by untrained personnel. Early presentation and management gives the best outcome. Recommendation: Only trained personnel should carry out circumcision. When parents or caregivers notice any unusual change post circumcision, they should present immediately to the hospital.