A surgical challenge: Idiopathic scrotal elephantiasis

Abstract

Scrotal elephantiasis is a condition rarely encountered in developed nations. It is endemic in tropical regions due to the presence of filariasis (Wucheria bancrofti). We report 2 cases of idiopathic scrotal elephantiasis in Canadian citizens with no history of travel to endemic filariasis regions, malignancy, surgery or radiation. Both patients underwent complete excision of the involved tissue with reconstruction. We found that for advanced cases of scrotal lymphedema, surgery is currently the only solution. In our cases of advanced idiopathic disease, surgical treatment combining the expertise of a plastic surgeon and a urologist provided a successful functional and cosmetic result.

Idiopathic Scrotal Elephantiasis

“…1,7 Given the size of the mass and the deep anemia of chronic disease secondary to frequent infections due to genital hygiene issues, surgery was the treatment proposed to our patient. While there are cases in the literature that report sedimentation and high CRP 9 , no cases are reported that describe concomitant deep anemia of chronic disease. In our case, the wound was stabilized following antibiotherapy and regional debridement.…”

“…6,[8][9][10][11][12][13][14][15][16] Reports on isolated penoscrotal lymphedema cases consist of chronic occurrences. In cases affecting the penis-although not a conclusive concept in treatment-penis reconstructions are performed using skin grafting 7,9,10 and local flaps from surrounding healthy tissues and by advancing the foreskin to the proximal. 1,7,10,12 In scrotal reconstruction, skin flaps taken from the superior or the lateral are used following orchiopexy.…”

“…In cases which this option is not possible, fasciocutaneous transposition or advancement flaps taken from medial thighs are used. 9,16 Reported early postoperative complications include hematoma and opening of the wound, and long-term complications include chronic scrotal sinus. 1,7 Given the size of the mass and the deep anemia of chronic disease secondary to frequent infections due to genital hygiene issues, surgery was the treatment proposed to our patient.…”

Tíz kilogrammos scrotalis elephantiasis műtéti megoldása

“…A nyirokutak helyreállítását ma a nyirokutak anasztomózisa, vagy nyirokér-véna anasztomózis képzése útján végzik. Kisfokú, kimutatható nyirokút-elzáródás esetén alkalmazható ez az eljárás még a hegesedés megjelenése előtt (8).…”

Penoscrotal elephantiasis: Case report

“…The majority of cases are due to filarial parasites Wucheria bancrofti, less often due to bacterial sexually transmitted infections, such as lymphogranuloma venerum and donovanosis. The other, rare causes include leishmaniasis, tuberculosis, pelvic and abdominal or haematological malignancy as well as its therapy, continuous ambulatory peritoneal dialysis or dermatological diseases, most commonly lichen simplex chronicus and hidradenitis suppurativa [3][4][5][6][7].…”