V11-02 PENILE-SCROTAL RECONSTRUCTION DUE TO MALE GENITAL LYMPHOEDEMA

Abstract

You have accessJournal of UrologyCME1 Apr 2023V11-02 PENILE-SCROTAL RECONSTRUCTION DUE TO MALE GENITAL LYMPHOEDEMA Matthew Megson, Wai Gin Lee, and David Ralph Matthew MegsonMatthew Megson More articles by this author , Wai Gin LeeWai Gin Lee More articles by this author , and David RalphDavid Ralph More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003337.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: This is a case of scrotal lymphoedema in a 36 year old gentleman who had had 3 years of recurrent infections. Due to the extent of the disease he required an excision of the lymphoedematous tissue and a scrotoplasty to reconstruct his scrotum from unaffected skin. METHODS: This is a video demonstrating the steps of the excision of the lymphoedematous tissue and subsequent reconstructive. Steps of the procedure start with marking of the lymphoedematous tissue. The surgeon the dissects down the isolate the cords and delivers the testes. The penile shaft can then be isolated and all lymphoedematous tissue excised. With the important structures now isolated, the scrotal lymphoedematous tissue can be removed. Care must be taken to keep the unaffected skin on the lateral aspects of the wounds, as these have a different lymphatic drainage and are therefore not involved in the pathology. This creates an ideal tissue for reconstruction as this allows primary closure of the neo-scrotum. The lymphoedematous tissue tends to be extremely vascular with large feeding vessels, therefore care much be taken with haemostasis. Due to the lymphoedematous tissue extending into the patients perineum he was then placed into lithotomy to allow better access to this area. Care was taken to avoid injury to the anus and rectum. Prior to the close of the neo-scrotum an Orchidopexy was performed to stop testicular retraction. The lateral skin was then closed to create a neo-scrotum over drains. RESULTS: The video shows a typical operation for male genital lymphoedema and the usual end results. The patient is happy with his final result. The histology showed an anogenital granulomatosis lymphoedema. CONCLUSIONS: A variety of treatment options for anogenital granulomatosis exist though if left to become severe then surgery is required before any of these medications would improve future outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e999 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Megson More articles by this author Wai Gin Lee More articles by this author David Ralph More articles by this author Expand All Advertisement PDF downloadLoading ...