Proposal for an Anatomical Scale for the Prognosis of Fournier Syndrome

Objective: To describe the morbidity and mortality of patients with Fournier's syndrome who undergo 3-stage reconstructive surgery and their prognosis according to the anatomic affectation. Methods: In this retrospective study, we analyzed 58 patients with Fournier's syndrome who underwent a three-stage reconstructive technique at the General Hospital Zone No. 1 of Mérida, Yucatán, by the same surgeon between 2021 and 2024. The primary endpoint was mortality of patients with Fournier's syndrome who underwent three-stage reconstructive surgery and their prognosis according to the anatomical involvement. Results: The study closed after 3 years with 58 patients (all men; mean age 64-years). The most frequent comorbidity was diabetes mellitus in 93% (n = 54). An anatomic scale was proposed according to the affected area, which was correlated with prognostic scales and its relationship with days of hospital stay. Grade I and grade II injuries were correlated to a hospital stay of less than 7 days. The average hospital stay was 13.5 days (4-22 days). The most frequent site of affection was scrotal at 70% (N = 44), and mortality was 6.8% (N = 4). Conclusions: Fournier's gangrene is a frequent entity in our hospital with characteristics similar to those reported in the world literature; this study is one of the largest series of cases reported so far in our country. In patients who complete the 3-stage reconstructive technique, the prognosis is promising: low urological complications and lower hospital stay and mortality than reported in other studies.