title: Surgical Reconstruction of Giant Penoscrotal Lymphedema in Sub-Saharan Africa.
abstract: To present management challenges, surgical technique, and outcome associated with penoscrotal reconstruction in patients with giant scrotal lymphedema in sub-Saharan Africa.
  
  
  
  A prospective study of all patients who had penoscrotal reconstruction for giant scrotal lymphedema at our university teaching hospital between January 2003 and December 2012 was carried out. Patients' preoperative clinical evaluation findings, operative technique, and postoperative course were reviewed after obtaining ethical approval and informed consent from the patients.
  
  
  
  Nineteen patients with giant scrotal lymphedema presented to us during the period of study; out of which, 11 had surgical excision and were studied. Their mean age and median duration of symptoms were 48.5 years and 11.5 years respectively. They all had surgical reconstruction using modified Charles procedure by the same combined team of urologists and plastic surgeons. Scrotal hematoma (27.3%) and superficial surgical site infection (18.2%) were complications encountered postoperatively. One patient (9.1%) had recurrence within 24 months, requiring repeat excision.
  
  
  
  Giant scrotal lymphedema poses severe physical challenge to the sufferer. Surgery remains the only hope to reduce penoscrotal size. Combined effort of urologic and plastic surgeons is essential for reconstruction.
authors.affiliation: Urology Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria; Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria. Electronic address: kayosalako@yahoo.com.
authors.forename: Ayo A
authors.initials: AA
authors.lastname: Salako
authors.affiliation: Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria; Plastic surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
authors.forename: Jimoh K
authors.initials: JK
authors.lastname: Olabanji
authors.affiliation: Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria; Plastic surgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
authors.forename: Ayodeji O
authors.initials: AO
authors.lastname: Oladele
authors.affiliation: Department of Surgery, Federal Medical Centre, Owo, Ondo State, Nigeria.
authors.forename: Gideon H
authors.initials: GH
authors.lastname: Alabi
authors.affiliation: Department of Surgery, Federal Medical Centre, Owo, Ondo State, Nigeria.
authors.forename: Ifedayo E
authors.initials: IE
authors.lastname: Adejare
authors.affiliation: Urology Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
authors.forename: Rotimi A
authors.initials: RA
authors.lastname: David
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara; D005832:Genital Diseases, Male / Q000473:pathology / Q000601:surgery; D006801:Humans; D008209:Lymphedema / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010409:Penile Diseases / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D012611:Scrotum; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D055815:Young Adult