Reduction perineoplasty for scrotal elephantiasis: a method of surgical reconstruction of the penis and scrotum

Abstract

Scrotal elephantiasis can be insidious in onset, idiopathic as to cause and debilitating in progress. The massive scrotal enlargement results in a sac-like structure that first envelopes and then completely covers the penis, testes and the regional spermatic cord structures, causing loss of topographic identification. The urethra leads into a stratified, squamous epithelial-lined canal, which traverses the edematous subcutaneous tissue to open irregularly at the inferior aspect of the scrotal bag. The difficulty of acquiring sustained periods of cleanliness, the incontinence of urine despite an intact urethral sphincter, the unesthetic gross appearance and the loss of libido and mechanical copulation function are the significant symptoms and signs that indicate the extent of the debility. A form of treatment that would alleviate this distressful state and would be feasibly applicable should be worthy of critical consideration. Therefore, a case of a reduction scrotoplasty (reduction perineoplasty) for idiopathic lymphedema of the penis and scrotum is presented.