Reconstructive surgery for giant penoscrotal elephantiasis: about one case (original) (raw)
Penile and scrotal plasty for genital elephantiasis: A case report
Introduction: Filarial penoscrotal elephantiasis is a chronic lymphangitis with hypertrophy of the external genital organs (EGO) and still exists in countries with endemic filarial diseases. Case Report: We report a penile-scrotal elephantiasis case in a 20-year-old patient. He consulted for a scrotal mass reaching the knees with low urinary tract symptoms (LUTS) due to the burial of the penis. Excision followed by a scrotal skin plasty was performed. The aesthetic and the long-term functional results were satisfactory. Conclusion: The elephantiasis of external genital organs is becoming less and less frequent as a condition and surgery always occupies a place of choice in its management.
Surgical Correction of Peno-Scrotal Elephantiasis Nostras Verrucosa
IOSR Journals, 2019
Peno-scrotalelephantiasis nostras verrucosa is debilitating syndrome consisting of long standing lymphoedema of the penis and scrotum of non-filarialorigin, cutaneous features and occasional inguinal lymphadenopathy which precede the condition. A 36 year old man presented with several years history of genital swelling that occurred after developing inguinal lymphadenopathy from suspected lymphogranuloma venerum. Patient suffered inter-departmental shuttling with missed diagnoses of first lupus vulgaris and then condylomata acuminata of the penis and scrotum. Following series of incisional biopsy reports, initially upholding lupus vularis, then condylomata accuminata and finally elephantiasis nostras verrucosa, patient had scrotectomy, fulguration of penile shaft lesion, orchidopexy and reconstruction of a neoscrotum. Penoscrotal elephantiasis nostras verrucosa is scarcely reported in the literatures. Surgical correction is the main stay of treatment including excision of the scrotum, penile shaft skin and reconstruction of a neo-scrotum and penile shaft resurfacing.
A rare case report of large bilateral vulval elephantiasis
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Elephantiasis, the result of chronic lymphedema, is characterized by gross enlargement of the limbs or genitalia. It occurs because of obstructive diseases of the lymphatic system. Genital elephantiasis is a common result of filariasis. Other causes are lymphogranuloma venereum. granuloma inguinale, carcinomas, lymph node dissection, irradiation and tuberculosis. Filarial elephantiasis of the female genitalia is extremely uncommon, about 1-2% of the total cases of filarial elephantiasis. Mrs. X, 25 years old female, P1L1, resident of a village in Bihar presented to gynaecology OPD of ABVIMS and Dr. RML Hospital on 06th January 2020 with complaint of huge progressively increasing vulval swelling since 3 years. Patient had come from Bihar for treatment. She had been showing in her native place for 2 years but now the lump had made her walking difficult. She did not give history of any drug given for treatment for filariasis. She gave history of being treated for pulmonary Koch 10 year...
Giant elephantiasis and inguino-scrotal hernia
PLoS neglected tropical diseases, 2017
A 65-year-old man presented in Beira Central Hospital, Mozambique, with a right scrotal mass (diameter 80 x 80 cm), evolved over 15 years. The patient could barely move, and his weight at admission was 142 kg (Fig 1A and 1B). History of previous diseases was unremarkable, his general condition was good, and he had normal vital parameters. Physical examination showed wrinkled and thickened scrotal skin and right leg and foot edema. Due to his physical condition, penile erection had been impossible for many years. The patient was hospitalized for surgery with a diagnosis of "giant elephantiasis of the scrotum with bilateral inguinal hernia". The man was HIV negative, and preoperative tests showed only a moderate anemia (hemoglobin [Hb] = 7.7 g/dL). The patient was treated with folic acid and multivitamin tablets for 2 months. Finally, he was transfused (4 U), and his Hb increased to 10.2 g/dL before surgery. Although guidelines suggest hygiene treatment with soap and water for 6 months and antibiotics therapy before surgery, it was not possible to accomplish this protocol, and we proceeded directly with surgery. Anesthesia was induced intravenously by atropine, 0.5 mg, fentanyl, 150 μg, and thiopental, 500 mg, and it was maintained by fentanyl, 75 μg per hour. The first step of the surgical procedure was the hydrocele's reduction, and 15 liters of a brown-colored liquid were aspirated from the mass. After this procedure, there remained a scrotal elephantiasis mass of 67 kg and a bilateral inguino-scrotal hernia. To proceed further with the procedure, it was necessary to do a Foley catheterization in order to get a careful dissection with cautery to delineate the penis circumferentially from the root of the scrotal lymphedema. A bilateral inguino-scrotal incision was performed. The right testis was stiff and impossible to isolate; the left one was atrophic, and it was not possible to find it. The only solution was to do a bilateral orchiectomy and leave the cords behind in an attempt to form an alternative pathway for lymphatic drainage. The right scrotum presented also a giant inguino-scrotal hernia containing the colon, ileum, and part of the jejunum. The hernia sac was well separated from the internal ring and was easily opened. A hyperemic, inflamed appendix was found; thus, an appendectomy was performed, and the bowels were reduced into the abdomen. The neck of the large hernia sac was transected at the midpoint of the inguinal canal, and the proximal part was sutured-ligated. A high ligation of the proximal sac was done, and the stump was reduced, deep underneath the internal ring. The distal sac was left in place. The hernia repair was finally performed with polypropylene mesh, according to the Lichtenstein tension
Medicine international, 2022
Massive scrotal elephantiasis is a rare disease that usually requires a surgical approach. Lymphedema of the genitalia can have a different presentation that requires different treatment. The present study describes the case of a 43-year-old Caucasian male patient by scrotal elephantiasis of unknown causes with a buried penis. A novel surgical technique was applied for the treatment of massive scrotal elephantiasis and the authors present this single-center experience. Magnetic resonance imaging revealed the integrity of the corpora cavernosa, the spermatic cords, as well as the testes. The patient underwent a scrotectomy using a 'hanger-shaped incision' followed by scrotal reconstruction to obtain an adequate cosmetic outcome. The surgical approach to this uncommon disease is referred to as a 'hanger-shaped incision'. As demonstrated herein, this novel technique permits the formation of a trapezoidal cavity that allows the reconstruction of a neo-scrotum, a neo-septum and partially restoring the natural appearance of the genitalia.
Dermatopathology
Background: A plethora of diseases manifest as acquired genital lymphangiectasias which clinically manifest as superficial vesicles. They range from infections such as tuberculosis to connective tissue diseases such as scleroderma and even malignancy. Amongst infectious etiologies, lymphatic filariasis leads as the cause for lymphatic obstruction. Despite this, acquired lymphangiectasias due to this cause are not commonly reported. An unusual case of acquired scrotal lymphangiectasia secondary to filariasis is detailed in this paper with dermoscopic and histologic findings. Methods: A 65-year-old male farmer presented with multiple, asymptomatic vesicles over the scrotum with thickened scrotal and penile skin that had occurred for six years. He gave past history of intermittent fever and milky urine, was diagnosed with filariasis and treated with diethylcarbamazine for a year, four years previously. Systemic complaints abated but the peno-scrotal lesions did not. Results: Polarized ...
Penile reconstruction in the male
Arab Journal of Urology, 2013
We describe and review the most recent techniques of male genital reconstruction, identifying relevant material with an unstructured PubMed-based search of previous reports, using the keywords 'reconstruction', 'glans', 'shaft', 'lymphoedema', 'skin graft', 'scrotoplasty', 'urethroplasty', and 'penile prosthesis'. This search produced 22 reports that were analysed in this review. Split-thickness skin grafts are ideal for glans reconstruction, while full-thickness skin grafts should be used to cover defects on the shaft penis, as they tend to heal with less contracture. The radial artery-based free-flap phalloplasty is the technique of total phallic reconstruction associated with the highest satisfaction rates. Further research is required to identify an ideal reconstructive technique that would guarantee superior cosmetic and functional results, minimising donor site morbidity. ª 2013 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology.
Genital elephantiasis as a complication of chromoblastomycosis: A diagnosis overlooked
Indian Journal of Sexually Transmitted Diseases and AIDS, 2009
Over the decades, causes of genital elephantiasis have changed only to become elusive to etiological diagnosis. This is a case of 20 year old male who presented with genital elephantiasis occurring due to lymphatic obstruction caused by chromoblastomycosis and super added erysipelas. The diagnosis of chromoblastomycosis was clenched by biopsy. We describe this case for the rarity of its occurrence.