Aesthetic Reconstruction of Peno-Scrotal Lymphedema: Refinements of Previous Technique

Document Type : Original Article

Authors

The Department of Plastic and Maxillofacal Surgery, Faculty of Medicine, Ain Shams University, Cairo

Abstract

Background: Lymphedema is emotionally frustrating
disease due to its progressive course and no definite curative
methods of treatment, it was found that lymphedema results
from local and/or systemic failure of the lymphatic transport
system, and according to its cause and onset of lymphedema
it is classified into primary and secondary lymphedema.
Treatment methods of scrotal lymphedema and reconstruction
were limited in the literature to lymphangioplasty or direct
excision of the involved tissue and local tissue reconstruction.
The current study present patients with established scrotal
lymphedema and the way of surgical management in excision
and reconstruction.
Patients and Methods: Ten male patients were involved
in the study, their age was ranging between 25-60 years, three
patients were primary lymphedema, seven patients were
secondary lymphedema.
Results: Patients in the study were followed-up postoperatively
for a minimum 6-month period, it was found that a
clear improvement of the aspect of the external genitalia and
subsequent improvement of ambulation, hygiene, and ability
to void in the standing position occurred for all patients.
Conclusion: The procedure is effective giving good results
with no major complications were recorded, the technique
based on anatomical background that is why recurrence was
not recorded.

Keywords

Main Subjects

References

D'Alessandro A., Clement C.C. and Santambrogio L.:
Lymph formation, composition and circulation: A proteomics
perspective. Hansen KC, Int. Immunol., 27: 219-
27, 2015.
2- Liao S. and Von Der Weid P.Y.: Lymphatic system: An
active pathway for immune protection. Semin. Cell Dev.
Biol., 38: 83-9, 2015.
3- Ruocco V., Schwartz R.A. and Ruocco E.: Lymphedema:
An immunologically vulnerable site for development of
neoplasms. J. Am. Acad. Dermatol., 47: 124-7, 2002.
4- Rockson S.G.: The lymphatics and the inflammatory
response: Lessons learned from human lymphedema.
Lymphat. Res. Biol., 11: 117-20, 2013.
5- Current Concepts in the Surgical Management of Lymphedema.
6- Pramod Kumar M.S., M.Ch., D.N.B. and Gurusamipalayam
Periyasamy Navaneethan, M.B.B.S. Resection
of Scrotal Lymphedema.
7- Capuano G.P. and Capuano C.: Surgical management of
morbidity due to lymphatic filariasis: The usefulness of
a standardized international clinical classification of
hydroceles. Trop. Biomed., 29: 24-38, 2012.
8- Ikram Safe, M.D.: Peno-scrotal lymphoedema; one-stage
350 Vol. 43, No. 2 / Aesthetic Reconstruction of Peno-Scrotal Lymphedema
reconstruction. Egyptian Journal of Plastic & Reconstructive
Surgery. Jan., 21-8, 1993.
9- Farina R. and Farina G.: Elefantíase peno-escrotal (osqueofaloplastia).
Rev. Bra. Cir., 85: 20512, 1995.
10- Modolin M., Mitre A.I., Da Silva J.C.F., Cintra W.,
Quagliano A.P., Arap S. and Ferreira M.C.: Surgical
treatment of lymphedema of the penis and scrotum.
Clinics, 61 (4): 289-94, 2006.
11- Huang G.K., Hu R.Q., Liu Z.Z. and Pan G.P.: Microlymphaticovenous
anastomosis for treating scrotal elephantiasis.
Microsurgery, 6: 36-9, 1985.
12- Mukenge S.M., Pulitanó C., Colombo R., Negrini D. and
Ferla G.: Secondary scrotal lymphedema: A novel microsurgical
approach. Microsurgery, 27: 655-6, 2007.
13- Sappey M.P.C.: Anatomie, Physiologie, Pathologie des
vaisseaux lymphatiques. Paris: Adrien Delahaye, 1874.
14- Adil Kallat, Ahmed Ibrahimi, Hani Abousaleh, Hachem
El-Sayegh, Ali Iken, Lounis Benslimane and Yassine
Nouini: Scrotal Elephantiasis: About One Case and Literature
Review. International Journal of Current Innovation
Research, Vol. 3, Issue 04, pp 668-70, April 2017.
15- Dandapat M.C., Mohapatro S.K. and Patro S.K.: Elephantiasis
of the penis and scrotum: A review of 350 cases.
Am. J. Surg., 149: 686, 1985.
16- Martinez R.E., Couchell S.H., Raffel B. and Swartz W.M.
Primary lymphedema of the scrotum: Surgical treatment
and reconstruction. Ann. Plast. Surg., 21: 354, 1988.
17- Apesos J. and Anigian G.: Reconstruction of penile and
scrotal lymphedema. Ann. Plast. Surg., 27: 570, 1991.
18- Konety B.R., Cooper T., Flood H.D. and Futrell J.W.:
Scrotal elephantiasis associated with hidradenitis suppurativa.
Plast. Reconstr. Surg., 97: 1243, 1996.
19- Ndoye A., Sylla C., Ba M., Gueye S.M. and Diagne B.A.:
Point of technique: Management of penile and scrotal
elephantiasis. B. J. U. Int., 84: 362, 1999.
20- Tammer M.E., Plogmeier K. and Schneider W.: Surgical
therapy of scrotal edema in elephantiasis congenita hereditaria
(Meige type). Urologe A., 41: 493, 2002

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