title: Surgical management of scrotal lymphedema using local flaps.
abstract: Lymphedema affects all parts of the body, including the scrotum and penis. Genital lymphedema can be a functionally and emotionally incapacitating problem for patients. Patients suffer pain, chronic irritation, repeated infections, drainage, and sexual dysfunction. No ideal surgical or medical therapy exists for the treatment of male genital lymphedema. Fasciocutaneous thigh flaps have been used for coverage of the testes after scrotal lymphedema resection, but these flaps alter testicular thermoregulation and may cause infertility. Skin grafts have also been used for coverage. Use of posteriorly based perineal flaps may preserve perirectal lymphatics that provide collateral lymphatic drainage. We present 2 cases of severe scrotal lymphedema treated by lymphangiectomy and reconstruction with local flaps. Both patients were satisfied with their results and had improved quality of life. We present our miniseries of scrotal lymphedema treated by excision and anterior and posterior flap reconstruction as a successful treatment of this difficult problem.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA. thalperin@partners.org
authors.forename: Terri J
authors.initials: TJ
authors.lastname: Halperin
authors.forename: Sumner A
authors.initials: SA
authors.lastname: Slavin
authors.forename: Aria F
authors.initials: AF
authors.lastname: Olumi
authors.forename: Loren J
authors.initials: LJ
authors.lastname: Borud
mesh_terms: D006801:Humans; D008209:Lymphedema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010409:Penile Diseases / Q000601:surgery*; D010502:Perineum; D019651:Plastic Surgery Procedures / Q000379:methods*; D012611:Scrotum; D013524:Surgical Flaps