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Peno-Scrotal Elephantiasis: An Observation and Literature Review

Received: 18 March 2021     Accepted: 1 April 2021     Published: 13 April 2021
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Abstract

Scrotal elephantiasis is a rare pathology Peno-scrotal elephantiasis (scrotal lymphedema) is most common in endemic filarian areas. Outside these areas this pathology remains quite rare. We report a case of primitive peno-scrotal elephantiasis. A 60-year-old patient with no significant pathological history, who had a significant increase of the bursa volume that had been evolving for years. The clinical examination found a bursary 46 cm in diameter with thickened skin and a penis buried in a glove finger. Exploration of the vascular axis of the lower limbs was normal. Peri-scrotal MRI noted significant infiltration of inflammatory-looking scrotal tunics, but found no obstructive cause. The patient was treated by a complete surgical resection of the pathological tissue and a peno-scrotal reconstruction. The evolution was marked by a progressive healing of the surgical wound, the patient was reviewed several times to assess the benefit of the treatment, he noted a satisfaction of the surgery allowing a good functional and aesthetic result. The aim of this case report is to present a specific management of a peno-scrotal elephantiasis in our hospital and to compare it with the review of literature on surgical management of this pathology. This condition is uncommon and challenging to manage for most urologists.

Published in International Journal of Clinical Urology (Volume 5, Issue 1)
DOI 10.11648/j.ijcu.20210501.15
Page(s) 21-24
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Elephantiasis, lymphedema, Scrotum, Surgical Excision

References
[1] Apesos J, Anigian G. Reconstruction of Penile and Scrotal Lymphedema: Ann Plast Surg. 1991 Dec; 27 (6): 570–3.
[2] Dandapat MC, Mohapatro SK, Patro SK. Elephantiasis of the penis and scrotum. A review of 350 cases. Am J Surg. 1985 May; 149 (5): 686–90.
[3] Judge N, Kilic A. Elephantiasis Nostras Verrucosa. Excision with full-thickness skin grafting of the penis, scrotum, and perineal area. J Dermatol Case Rep. 2016 Nov 13; 10 (2): 32–4.
[4] Khedroo LG. Reduction perineoplasty for scrotal elephantiasis: a method of surgical reconstruction of the penis and scrotum. J Urol. 1976 Nov; 116 (5): 679–80.
[5] Ross JH, Kay R, Yetman RJ, Angermeier K. Primary lymphedema of the genitalia in children and adolescents. J Urol. 1998 Oct; 160 (4): 1485–9.
[6] Masson E. Pathologie inflammatoire du scrotum [Internet]. EM-Consulte. [cited 2021 Feb 4]. Available from: https://www.em-consulte.com/article/22760/pathologie-inflammatoire-du-scrotum.
[7] Fulmer LR, Fye C. Elephantiasis of the scrotum. J Clin Ultrasound. 1982 Mar; 10 (3): 143–4.
[8] Wille S, Niesel T, Breul J, Hartung R. Elephantiasis of the legs with lichen sclerosus et atrophicus of the penis and scrotum. J Urol. 1997 Jun; 157 (6): 2262.
[9] Ollapallil JJ, Watters DAK. Surgical management of elephantiasis of male genitalia. Br J Urol. 1995 Aug; 76 (2): 213–5.
[10] Hussain O, Faris R, Weil GJ, Ramzy RM, El Setouhy M. Bancroftian filariasis in Egypt: visualization of adult worms and subclinical lymphatic pathology by scrotal ultrasound. Am J Trop Med Hyg. 1998 Dec 1; 59 (6): 864–7.
[11] Liu J-C, Liu X-G, Xu C, Zhao H-F, Jiang X-Z. Scrotal elephantiasis associated with follicular occlusion triad: A case report and literature review. Medicine (Baltimore). 2019 Apr; 98 (16): e15263.
[12] Slama A, Jaidane M, Elleuch A, Ben Sorba N, Yacoubi MT, Mosbah AF. [Surgical treatment of penile-scrotal elephantiasis]. Progres En Urol J Assoc Francaise Urol Soc Francaise Urol. 2002 Apr; 12 (2): 337–9.
[13] Kirakoya B, Zango B, Paré AK, Kaboré AF, Yaméogo C. Reconstructive surgery for giant penoscrotal elephantiasis: about one case. Basic Clin Androl. 2014; 24: 16.
[14] Huang G-K, Hu R-Q, Liu Z-Z, Pan G-P. Microlymphaticovenous anastomosis for treating scrotal elephantiasis. Microsurgery. 1985; 6 (1): 36–9.
[15] Huang GK. [Microsurgical therapy of scrotum elephantiasis]. Z Urol Nephrol. 1989 Sep; 82 (9): 459–62.
[16] Konety BR, Cooper T, Flood HD, Futrell JW. Scrotal elephantiasis associated with hidradenitis suppurativa. Plast Reconstr Surg. 1996 May; 97 (6): 1243–5.
[17] Moussa Y, Moussa M, Abou Chakra M. Penoscrotal Elephantiasis nostras verrucosa: A case report and literature review. Int J Surg Case Rep. 2019; 65: 127–30.
[18] Hattori Y, Hayata N, Nakamura K, Takahashi T, Mitsumori K, Ohnishi H. Successful surgical resection and reconstruction of scrotal elephantiasis. IJU Case Rep. 2021 Mar; 4 (2): 79–81.
[19] Holman CM, Arnold PG, Jurkiewicz MJ, Walton KN. Reconstruction of male external genitalia with elephantiasis. Urology. 1977 Dec; 10 (6): 576–8.
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Cite This Article
  • APA Style

    Mohammed Mzyiene, Mustapha Ahsaini, Ziba Ouima Justin Dieudonne, Somuah Tenkorang, Mellas Soufiane, et al. (2021). Peno-Scrotal Elephantiasis: An Observation and Literature Review. International Journal of Clinical Urology, 5(1), 21-24. https://doi.org/10.11648/j.ijcu.20210501.15

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    ACS Style

    Mohammed Mzyiene; Mustapha Ahsaini; Ziba Ouima Justin Dieudonne; Somuah Tenkorang; Mellas Soufiane, et al. Peno-Scrotal Elephantiasis: An Observation and Literature Review. Int. J. Clin. Urol. 2021, 5(1), 21-24. doi: 10.11648/j.ijcu.20210501.15

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    AMA Style

    Mohammed Mzyiene, Mustapha Ahsaini, Ziba Ouima Justin Dieudonne, Somuah Tenkorang, Mellas Soufiane, et al. Peno-Scrotal Elephantiasis: An Observation and Literature Review. Int J Clin Urol. 2021;5(1):21-24. doi: 10.11648/j.ijcu.20210501.15

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  • @article{10.11648/j.ijcu.20210501.15,
      author = {Mohammed Mzyiene and Mustapha Ahsaini and Ziba Ouima Justin Dieudonne and Somuah Tenkorang and Mellas Soufiane and Jalal Eddine Elammari and Mohammed Fadl Tazi and Mohammed Jamal Elfassi and Moulay Hassan Farih},
      title = {Peno-Scrotal Elephantiasis: An Observation and Literature Review},
      journal = {International Journal of Clinical Urology},
      volume = {5},
      number = {1},
      pages = {21-24},
      doi = {10.11648/j.ijcu.20210501.15},
      url = {https://doi.org/10.11648/j.ijcu.20210501.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20210501.15},
      abstract = {Scrotal elephantiasis is a rare pathology Peno-scrotal elephantiasis (scrotal lymphedema) is most common in endemic filarian areas. Outside these areas this pathology remains quite rare. We report a case of primitive peno-scrotal elephantiasis. A 60-year-old patient with no significant pathological history, who had a significant increase of the bursa volume that had been evolving for years. The clinical examination found a bursary 46 cm in diameter with thickened skin and a penis buried in a glove finger. Exploration of the vascular axis of the lower limbs was normal. Peri-scrotal MRI noted significant infiltration of inflammatory-looking scrotal tunics, but found no obstructive cause. The patient was treated by a complete surgical resection of the pathological tissue and a peno-scrotal reconstruction. The evolution was marked by a progressive healing of the surgical wound, the patient was reviewed several times to assess the benefit of the treatment, he noted a satisfaction of the surgery allowing a good functional and aesthetic result. The aim of this case report is to present a specific management of a peno-scrotal elephantiasis in our hospital and to compare it with the review of literature on surgical management of this pathology. This condition is uncommon and challenging to manage for most urologists.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Peno-Scrotal Elephantiasis: An Observation and Literature Review
    AU  - Mohammed Mzyiene
    AU  - Mustapha Ahsaini
    AU  - Ziba Ouima Justin Dieudonne
    AU  - Somuah Tenkorang
    AU  - Mellas Soufiane
    AU  - Jalal Eddine Elammari
    AU  - Mohammed Fadl Tazi
    AU  - Mohammed Jamal Elfassi
    AU  - Moulay Hassan Farih
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    N1  - https://doi.org/10.11648/j.ijcu.20210501.15
    DO  - 10.11648/j.ijcu.20210501.15
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 21
    EP  - 24
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20210501.15
    AB  - Scrotal elephantiasis is a rare pathology Peno-scrotal elephantiasis (scrotal lymphedema) is most common in endemic filarian areas. Outside these areas this pathology remains quite rare. We report a case of primitive peno-scrotal elephantiasis. A 60-year-old patient with no significant pathological history, who had a significant increase of the bursa volume that had been evolving for years. The clinical examination found a bursary 46 cm in diameter with thickened skin and a penis buried in a glove finger. Exploration of the vascular axis of the lower limbs was normal. Peri-scrotal MRI noted significant infiltration of inflammatory-looking scrotal tunics, but found no obstructive cause. The patient was treated by a complete surgical resection of the pathological tissue and a peno-scrotal reconstruction. The evolution was marked by a progressive healing of the surgical wound, the patient was reviewed several times to assess the benefit of the treatment, he noted a satisfaction of the surgery allowing a good functional and aesthetic result. The aim of this case report is to present a specific management of a peno-scrotal elephantiasis in our hospital and to compare it with the review of literature on surgical management of this pathology. This condition is uncommon and challenging to manage for most urologists.
    VL  - 5
    IS  - 1
    ER  - 

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Author Information
  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

  • Urology Division, Centre Hospitalier Universitaire Hassan II, University Sidi Mohamed Ben Abdellah, Fez, Morocco

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