Scrotal Gangrene: Adventures in Medical Journalism

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Jordan Davidson
I’ve been talking about scrotal gangrene a lot lately.

Be it a casual conversation with co-workers, a date, or a telephone call with my mom; I have somehow managed to sprinkle scrotal gangrene into almost every social interaction (in hindsight, perhaps I should apologize for this).

I’ll explain. I’m a health journalist. During the day I edit and produce news pieces, women’s health, digestive health, thyroid health and columns written by patients and doctors. Outside of my day job, I run a support organization for women with endometriosis. My typical day consists of talking about uncomfortable medical topics and then going home and talking about (or writing about, etc…) menstruation.  Needless to say, if we were to play the penis game (the game where the person who can yell penis the loudest, wins) — I would win.

Sometimes, I have some extra free-time in which I freelance as a technical medical writer. When I started writing, I was asked what my specialty was — to which, naturally, I replied ‘women’s health.’  So you can imagine my surprise when I was assigned a piece on Fournier gangrene (aka scrotal gangrene).

Based on the amount of research I did for that piece,  I am fairly confident that I could (should the occasion ever arise) identify scrotal gangrene. Scratch that — based on the number of necrotizing penises, scrotums and perineums that ambushed my computer screen, I am fairly certain I could diagnose scrotal gangrene as unfortunately, those images are not something easily forgotten.

How does one get scrotal gangrene you ask?  In order for gangrene to occur in the genitourinary or anorectal region you need several different types of bacteria to intermingle somewhere around an open wound, rash, burn or any sort of opening in which bacteria could fester. The most common type of bacteria found in Fournier gangrene cultures is E.coli (which is also found in the digestive tract and in feces).

When this bacteria combo makes its way into the body it can cause fever and edema (a type of swelling) in the affected areas. In a matter of hours the skin can begin to necrotize and if not caught quickly, can lead to excess debridement (the shaving off of layers of skin), organ amputation, sepsis and death.  Fortunately, Fournier gangrene is incredibly rare and even rarer in women (who can get perineal and vulvar gangrene).

When scrotal gangrene does occur it usually occurs in older people and people with compromised immune systems.  Although… There was this one case; regarding a 29 year old male, who masturbated so frequently that he had friction burns. Guess what happened to the friction burns — they got infected, and he developed Fournier gangrene on his penis. He survived but I can’t imagine the procedure to remove the necrotizing skin was all too pleasant.

And that my friends, is why I got into health journalism; so I could teach the world about the importance of personal hygiene. Just kidding… It was to have fun facts to make people feel uncomfortable at parties.

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2 Comments

  1. As the author of this piece, a health journalist and patient advocate, I take my job incredibly seriously. I often get the opportunity to write about men’s health and less commonly women’s health because of the divide that occurs between what is polite conversation in healthcare. This was a piece of satire and while yes, satire can be offensive, it often makes for the best dialogue on real issues. The Onion often puts out pieces satirizing serious international news (such as Syria’s use of Sarin gas). Last month The Atlantic published a satirical piece on egg freezing that would have had any woman struggling with infertility seething in rage. And don’t forget (the best and most well-known piece of satire) Jonathan Swift’s “A Modest Proposal” in which he solves Ireland’s overpopulation and famine issues by exclaiming the Irish should eat their children. Of which, was also met with rage as to his ‘flippant’ take on a serious issue. Did Swift really think the Irish should eat their young? No. Did I really become a journalist so that I could make people uncomfortable at parties? No. My piece was a work of satire, a play on breaking the polite boundaries that exist in healthcare. I would write a piece satirizing women’s health just as soon as I would write one satirizing men’s health. I became a health journalist to educate people and with only 750 reported cases of Fournier gangrene, I highly doubt the average person has ever even heard of it. I did not downplay the seriousness of the condition nor the ramifications. Did I highlight a case study that might have been a bit sensational, yes. However, I did also mention that, that case is the exception not the rule and that most cases do occur in people with compromised immune systems (older people, people with diabetes, etc..)

  2. What a shame that this female journalist gets an opportunity to delve into a men’s health issue and she decides to make light of it. I quote “It was to have fun facts to make people feel uncomfortable at parties.”
    As a caregiver and RN I found your take on this diagnosis not only flippant but offensive. Of all the significant co-morbidities of this condition(vascular disease, diabetes) you choose masturbation?
    If you are a health care reporter don’t act like you work for TMZ!

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