A survey on the knowledge, opinions, and approaches in clinical practice of urology physicians about hyperbaric oxygen therapy application in Fournier gangrene

Objective: Fournier gangrene is a form of necrotizing fasciitis with high mortality. Hyperbaric oxygen therapy (HBOT) is a successful and supportive treatment option for Fournier’s gangrene (FG). This study aimed to analyze urologists’ knowledge, opinions, and preferences about HBOT application in FG. Material and Methods: An online or face-to-face questionnaire was applied to physicians who are experts in the field of Urology or who have been continuing Urology residency training for at least one year. Results: Ninety urology physicians filled out the questionnaire. Most of them (56.4%) never refer FG cases to HBOT. Physicians (55.3%) mostly preferred HBOT only in patients unresponsive to surgical debridement and antibiotherapy. Besides, 27.3% of them stated they had no information when asked to self-assess their knowledge. Only 12 physicians (13.3%) had previously been in an HBOT center, and 15 (16.7%) physicians had participated in a scientific study on HBOT. Only three physicians (3.4%) stated HBOT was not beneficial to FG patients. Urologists’ opinions about HBOT efficiency in FG were examined (3-point-Likert type questions) in 5 questions; the median score was 2 points (minimum-maximum: 1-3 points). On the other hand, physicians who did not know HBOT had more negative opinions about HBOT efficiency in FG (p = 0.002). Conclusion: Urology physicians’ knowledge of HBOT, their doubts about HBOT in FG, and their relatively low experience with HBOT are clearly shown in this study. Therefore, urology physicians should be encouraged to increase their HBOT experience in FG and participate in scientific studies. Also, Urology Associations should discuss HBOT efficiency more effectively in guidelines and meetings. Keywords: Fournier’s gangrene, hyperbaric oxygenation, questionnaire, urologists