The Forgotten Suffering of Patients who Survived Fournier's Gangrene: A Systematic Review of Long-term Outcomes and Quality of Life Impairment.

Fournier's gangrene (FG) is a rare but life-threatening necrotizing fasciitis of the perineogenital region. While acute outcomes are well described, data on long-term morbidity remain scarce. We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant systematic review to describe long-term mortality, quality of life (QoL), and functional outcomes after FG. Of 3366 records screened, five retrospective studies (2007-2025) including 291 patients were eligible, all at moderate to critical risk of bias. In-hospital mortality ranged from 3% to 16% across studies. Long-term mortality ranged from 5% to 21%, with follow-up varying from 60 d to 11 yr. QoL and functional outcomes were inconsistently reported but suggested a substantial burden, including fecal incontinence, sexual dysfunction, urinary symptoms, and psychosocial impairment. Overall, available evidence indicates that FG carries a sustained burden beyond the acute phase; however, conclusions are limited by the scarcity and low methodological quality of existing studies. PATIENT SUMMARY: We reviewed studies on long-term outcomes after FG. Survivors often seem to experience lasting bowel, bladder, sexual, and social problems. Continued follow-up care is important to improve recovery and QoL.