Fournier Gangrene: a series of 12 patients

Fournier gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia, the perineum, or the abdominal wall that is associated with high morbidity and mortality. In this series, we describe 12 patients with Fournier gangrene who had presented to our medical center. Twelve men had been diagnosed with Fournier gangrene in Shohada-e- Tajrish hospital between March 2002 and September 2005. Their medical records were reviewed and the Fournier Gangrene Severity Index scores before and after the treatment were determined. Fifty percent of the patients were diabetic and their mean age was 58.2 ' 17.8 years. The mean delay between the onset of the disease and the admission was 4.9 days and the mortality rate was 16.6%. The median Fournier Gangrene Severity Index scores before the admission and at the time of discharge were 4.5 [range, 0 to 11] and 0 [range, 0 to 9], respectively [P = .005]. One of the patients who died had the scores of 11 and 9, respectively. Split-thickness skin graft was performed for 5 patients [41.7%]. In Fournier gangrene, a rapid diagnosis and emergent surgical intervention is crucial. The Fournier Gangrene Severity Index seems to be an excellent tool for outcome prediction

relation of enuresis and irritable bowel syndrome with premature ejaculation: a preliminary report

In this retrospective study, we reviewed the outpatient data of patients with premature ejaculation to investigate the association of that disorder with irritable bowel syndrome and a positive history of enuresis. All patients with premature ejaculation who had presented to the author's office from March 2002 to June 2003 were selected. Their medical records were reviewed, and data including symptoms of irritable bowel syndrome, history of enuresis, and psychologic disorders were collected. The results of our analysis were compared with the worldwide reported prevalence of enuresis and irritable bowel syndrome in the male general population. Forty-one consecutive patients were asked whether they had ever experienced irritable bowel syndrome, enuresis, psychologic problems, and/or the feeling of tickling or sexual pleasure at ejaculation. Of those 41 patients, 18 reported the symptoms of irritable bowel syndrome [43.9% versus 10% in the general population; P < .001]. A reliable answer about the history of enuresis was obtained from 35 patients, 14 of which had experienced that disorder [40% versus 10% in the general population; P < .001]. Of those 35 patients, 6 [17.4%] had experienced both irritable bowel syndrome and enuresis. Twenty-two of 37 patients [59.5%] reported psychologic problems including stress, agitation, and obsession-compulsive disorder. The results of this study suggest the association of premature ejaculation with irritable bowel syndrome and enuresis, which in turn may indicate that those disorders share a common neurologic pathophysiology. A special attention of the physicians to the symptoms of these diseases together may be of great help for the patients