Treatment of Lymphedema of the Scrotum and Penis Using Scrotal Flaps

음낭피판을 이용한 음낭과 음경 림프부종의 치료

  • Lee, Do-Heon (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Park, Sun-Hyung (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Park, Jung-Joon (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Hwang, Jae-Ha (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Kim, Kwang-Seog (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Lee, Sam-Yong (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School)
  • 이도헌 (전남대학교 의과대학 성형외과학교실) ;
  • 박선형 (전남대학교 의과대학 성형외과학교실) ;
  • 박정준 (전남대학교 의과대학 성형외과학교실) ;
  • 황재하 (전남대학교 의과대학 성형외과학교실) ;
  • 김광석 (전남대학교 의과대학 성형외과학교실) ;
  • 이삼용 (전남대학교 의과대학 성형외과학교실)
  • Received : 2011.07.29
  • Accepted : 2011.09.29
  • Published : 2011.11.10

Abstract

Purpose: Lymphedema of the scrotum and penis is a functionally and emotionally incapacitating problem for patients. Patients suffer pain from swelling, chronic irritation, repeated infections, drainage, and sexual dysfunction. Although there are various methods for the treatment of scrotal and penial lymphedema, achieving a satisfactory reconstruction in severe cases still remains a challenge due to the lack of locally available tissue. Methods: A 33-year-old man sustained severe lymphedema of the scrotum and penis. He reported a history of swelling since 25 years, which had been intensified during the past few months. There was no history of irritation, surgery, trauma, infection or travel to endemic countries. The authors reconstructed the scrotum and penis using 4 scrotal flaps made by incising the enlarged scrotum crucially. Results: The postoperative course was uneventful. Histopathologic examination showed nonspecific chronic inflammation. The patient was followed up for 18 months and a good reconstructive result was obtained with no recurrence. Conclusion: The authors' method is safe and easy to perform. This method may be a convenient and reliable alternative for the treatment of severe lymphedema of the scrotum and penis.

Keywords

References

  1. Morey AF, Meng MV, McAninch JW: Skin graft reconstruction of chronic genital lymphedema. Urology 50: 423, 1997 https://doi.org/10.1016/S0090-4295(97)00259-8
  2. Kuepper D: Giant scrotal elephantiasis. Urology 65: 389, 2005
  3. Halperin TJ, Slavin SA, Olumi AF, Borud LJ: Surgical management of scrotal lymphedema using local flaps. Ann Plast Surg 59: 67, 2007 https://doi.org/10.1097/01.sap.0000258448.17867.20
  4. Rahman GA, Adigun IA, Yusuf IF, Aderibigbe AB, Etonyeaku AC: Giant scrotal lymphedema of unclear etiology: a case report. J Med Case Reports 3: 7295, 2009 https://doi.org/10.1186/1752-1947-3-7295
  5. Gibson T: Delpech: his contributions to plastic surgery and the astonishing case of scrotal elephantiasis. Br J Plast Surg 9: 4, 1956 https://doi.org/10.1016/S0007-1226(56)80003-9
  6. Huang GK, Hu RQ, Liu ZZ, Pan GP: Microlymphaticovenous anastomosis for treating scrotal elephantiasis. Microsurgery 6: 36, 1985 https://doi.org/10.1002/micr.1920060107
  7. Kumar P, Navaneethan GP: Resection of scrotal lymphedema. Plast Reconstr Surg 116: 24e, 2005 https://doi.org/10.1097/01.prs.0000172979.73099.4e
  8. Dandapat MC, Mohapatro SK, Patro SK: Elephantiasis of the penis and scrotum. a review of 350 cases. Am J Surg 149: 686, 1985 https://doi.org/10.1016/S0002-9610(85)80156-2
  9. Guedes Neto HJ: Surgical treatment of penile-scrotal lymphedema. Lymphology 29: 132, 1996