A Le Fouler1,2, A Hamy1,2,3, J Barbieux1,2, V Souday4, P Bigot2,5, P Le Naoures1, R Jaouen1,2, C Brochard6,7, Aurélien Venara8,9,10,11. 1. Department of Digestive and Endocrinal Surgery, CHU Angers, 4 rue Larrey, 49933, Angers, France. 2. LUNAM, University of Angers, Angers, France. 3. UMR INSERM HIFI, Angers, France. 4. Intensive Care Unit and Department of Hyperbaric Medicine, CHU Angers, 4 rue Larrey, 49933, Angers, France. 5. Department of Urology, CHU Angers, 4 rue Larrey, 49933, Angers, France. 6. UMR INSERM U1235, TENS, Nantes, France. 7. Department of Gastroenterology, CHU Rennes, 2 rue Henri Le Guilloux, 35033, Rennes, France. 8. Department of Digestive and Endocrinal Surgery, CHU Angers, 4 rue Larrey, 49933, Angers, France. auvenara@yahoo.fr. 9. LUNAM, University of Angers, Angers, France. auvenara@yahoo.fr. 10. UMR INSERM HIFI, Angers, France. auvenara@yahoo.fr. 11. UMR INSERM U1235, TENS, Nantes, France. auvenara@yahoo.fr.
Abstract
PURPOSE: For survivors of perineal gangrene (PG), quality of life and functional prognosis of pelvic functions are probably overestimated. The aim of this study was to report long-term anal and urinary sphincter dysfunctions, sexual sequelae, and patients' quality of life after treatment of perineal gangrene. METHODS: This retrospective observational study was conducted in one university hospital over 16 years. Seventy-three patients experienced PG; 22 were subject to long-term follow-up. Three questionnaires were sent to patients to assess pelvic dysfunction and quality of life: the GIQLI, the Cleveland Incontinence Score, and the USP score for urinary dysfunction. Sexual sequelae were considered if orchiectomy or penile resection for male patients and vulvar resection for female patients were performed. RESULTS: Of the 72 patients included, seven died before discharge (9.7%) and at least 14 died during follow-up (19.4%), despite a mean age of 62 years (± 13). Among the surviving patients, seven experienced an alteration of their quality of life (44%) (GIQLI < 96). Six patients still had a colostomy, and among the remaining patients, 11 experienced minimal to mild incontinence (68.7%), while one experienced constipation (6.2%). One patient suffered from urinary incontinence (4.5%), and six suffered from dysuria (27.3%). Three male patients (14%) underwent an orchiectomy, and one female patient (100%) underwent a vulvar resection. CONCLUSION: PG leads to a high rate of anal and urinary dysfunctions. Urinary dysfunctions are taken into account and treated; however, anal incontinence is not investigated even though it could lead to decreased quality of life.
PURPOSE: For survivors of perineal gangrene (PG), quality of life and functional prognosis of pelvic functions are probably overestimated. The aim of this study was to report long-term anal and urinary sphincter dysfunctions, sexual sequelae, and patients' quality of life after treatment of perineal gangrene. METHODS: This retrospective observational study was conducted in one university hospital over 16 years. Seventy-three patients experienced PG; 22 were subject to long-term follow-up. Three questionnaires were sent to patients to assess pelvic dysfunction and quality of life: the GIQLI, the Cleveland Incontinence Score, and the USP score for urinary dysfunction. Sexual sequelae were considered if orchiectomy or penile resection for male patients and vulvar resection for female patients were performed. RESULTS: Of the 72 patients included, seven died before discharge (9.7%) and at least 14 died during follow-up (19.4%), despite a mean age of 62 years (± 13). Among the surviving patients, seven experienced an alteration of their quality of life (44%) (GIQLI < 96). Six patients still had a colostomy, and among the remaining patients, 11 experienced minimal to mild incontinence (68.7%), while one experienced constipation (6.2%). One patient suffered from urinary incontinence (4.5%), and six suffered from dysuria (27.3%). Three male patients (14%) underwent an orchiectomy, and one female patient (100%) underwent a vulvar resection. CONCLUSION:PG leads to a high rate of anal and urinary dysfunctions. Urinary dysfunctions are taken into account and treated; however, anal incontinence is not investigated even though it could lead to decreased quality of life.
Authors: L Abramowitz; I Sobhani; R Ganansia; A Vuagnat; J L Benifla; E Darai; P Madelenat; M Mignon Journal: Dis Colon Rectum Date: 2000-05 Impact factor: 4.585
Authors: E Eypasch; J I Williams; S Wood-Dauphinee; B M Ure; C Schmülling; E Neugebauer; H Troidl Journal: Br J Surg Date: 1995-02 Impact factor: 6.939