Severe elephantiasis of penis and scrotum

Prpić, Ivan

doi:10.1016/s0007-1226(66)80028-0

Cited by 18 publications

(9 citation statements)

References 16 publications

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“…In addition to the grotesque aspect, the progression of the condition impairs ambulation, makes sexual intercourse impossible, and impairs both voiding in the standing position and proper hygiene of the perineal region, with subsequent malodor and recurrent episodes of skin infections, resulting in cellulitis and lymphangitis, thus aggravating the anatomopathological presentation and causing severe damage to the patient's quality of life and self-esteem. 1,4,5,7 The lymphatic obstruction of the superficial chain of the inguinoscrotal region, responsible for the lymphatic drainage of the penile and scrotal skin, results in elephantiasis of the external genitalia. The deep chain is responsible for lymphatic drainage of the testes and penile body and flows into deep inguinal and abdominal lymph nodes, and is usually preserved.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] The involvement of the external genitalia causing a marked enlargement of its volume ( Figure 2) is an uncom- fortable clinical situation, with impairment of movement, hygiene procedures, voiding in the standing position, and sexual intercourse. 4,5,7 The lymphedema of the penis and scrotum is classified as primary when it is caused by lymphatic malformation, and as secondary when it results from lymphatic obstruction following parasitic and infectious diseases, or from other clinical conditions such as heart, liver and kidney diseases-or also from surgical or radiation therapy. 1,2,8 Since the response to medical therapy is poor, excision of the affected tissue is still the best option to treat this condition.…”

Section: Introductionmentioning

confidence: 99%

“…1,2,8 Since the response to medical therapy is poor, excision of the affected tissue is still the best option to treat this condition. [7][8][9][10][11][12][13][14][15][16] The objective of this study is to present our experience in treating penoscrotal lymphedema, as well as the results obtained by using the Charles procedure 11 and adding a tactical modification in cutaneous reconstruction of the penile shaft.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Lymphedema of the Penis and Scrotum

Modolin

Mitre

Silva

et al. 2006

Clinics

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. Surgical treatment of lymphedema of the penis and scrotum. Clinics. 2006;61(4):289-94. PURPOSE:Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. MATERIALS AND METHODS:Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. RESULTS: Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. CONCLUSIONS: The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Lymphedema of the Penis and Scrotum

Modolin

Mitre

Silva

et al. 2006

Clinics

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“…Complete excision of the diseased skin and subcutaneous tissue with wide dissection in the correct fascial plane is the recommended surgical treatment, this often results in a highly satisfactory outcome. The aims of the surgical treatment are to obtain a functional and cosmetically acceptable penis-and scrotum and prevention of recurrent lymphedema [2,4,10].…”

Section: Discussionmentioning

confidence: 99%

“…It is known that the denuded penis covered with carefully applied split thickness skin grafts yields the best results [2,9,10].…”

Section: Discussionmentioning

confidence: 99%

Total scrotal reconstruction with vertical rectus abdominis musculocutaneous (VRAM) flap in the treatment of penoscrotal lymphedema

et al. 1992

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A 37-year-old man with scrotal and penile lymphedema was treated by total excision of the scrotal and penile skin and subcutaneous tissue. Split thickness skin grafts were used to cover the penis and the pubic area. An inferiorly based left rectus abdominis muscle with a 12 x 16 cm skin island from the epigastric region was used to reconstruct the scrotum. The VRAM flap is a simple, reliable flap and it provides sufficient coverage of the exposed testicles after total excision of diseased scrotal skin. It also gives a satisfactory esthetic result. The VRAM flap may be another source for reconstruction of the total scrotum.

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Filarial lymphoedema and elephantiasis of lower limb: A review of 44 cases

Dandapat

Mohapatro

Mohanty

1986

Journal of British Surgery

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Twenty patients with early lymphoedema due to filariasis and twenty-four patients with elephantiasis of the lower limb were subjected to lymph nodovenous shunt (LNVS) and Charles' operation respectively. In 62 per cent of cases subjected to LNVS operation, there was a rapid relief of lymphoedema followed by slow reduction, 24 per cent had slow and gradual reduction and 14 per cent had very slight reduction in volume and circumference. Patients subjected to Charles' operation had immediate volume and circumference reduction and skin graft 'take' was 88 per cent. There were no operative and a few minor postoperative complications in both the procedures, infection being most notable in those who had undergone Charles' operation. The hospital stay was 7-10 days in LNVS and 21-36 days in Charles' operation. There was no mortality. The long-term results of the present study in terms of volume and circumference reduction, skin condition and freeness of joint movement were encouraging. It is concluded that, while excisional surgery such as Charles' operation becomes necessary for late states of lymphoedema which have progressed to elephantiasis, nodovenous shunt alone is sufficient to relieve early stages of lymphoedema due to filariasis.

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Severe elephantiasis of penis and scrotum

Cited by 18 publications

References 16 publications

Surgical Treatment of Lymphedema of the Penis and Scrotum

Surgical Treatment of Lymphedema of the Penis and Scrotum

Total scrotal reconstruction with vertical rectus abdominis musculocutaneous (VRAM) flap in the treatment of penoscrotal lymphedema

Filarial lymphoedema and elephantiasis of lower limb: A review of 44 cases

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