Self-reported Post-vasectomy Fournier's Gangrene Complication Among Practitioners

Abstract

ABSTRACT Introduction While several cases of Fournier's gangrene have been reported following vasectomy, the prevalence of this complication is yet to be elucidated. Objective Determine the prevalence, presentation and outcome of Fournier's gangrene post-vasectomy. Methods We developed a brief IRB exempt survey that was disseminated by email to the 250 high volume vasectomy practitioners who are part of a global networking list-serve to gather prevalence, presentation and outcome of this debilitating complication. The data was organized and analyzed via Microsoft Forms and Excel. Results 83/250 members responded to the survey (33%).Practitioners were: family practitioners 74.6% (62), urologists 19.2% (16), general surgeons 3.6% (3), internist 1.2% (1) and 1 Ob/Gyn. The mean self-reported number of vasectomies performed per provider was 574. 8.4% (7) of all practitioners routinely provide antibiotics prior to the procedure. The self-reported complication rate for Fournier's gangrene in this population was 6% (5). Of which majority noted the typical clinical presentation of fever (80%), pain (60%) and skin discoloration (60%). Among the practitioners who experienced Fournier's gangrene, none of them provided antibiotics prior to the procedure. However, these practitioners performed twice as many annual vasectomies than the non-Fournier's gangrene practitioner pool, 1160 versus 577, respectively. Among those with Fournier's gangrene post-vasectomy, all of them were managed with antibiotics and surgical debridement of which 60% (3) did not require ICU stay, 60%(3) had either temporary or permanent disability with only 20%(1) with complete resolution. Conclusions Globally, multiple specialties perform vasectomies. Fournier's gangrene is a rare yet debilitating complication that can result uncommonly after a vasectomy. The likelihood of encountering a Fournier's gangrene complication is positively associated with the number of vasectomies performed by a practitioner. Disclosure No