[Surgical therapy of scrotal edema in elephantiasis congenita hereditaria (Meige type)]

The underlying cause of primary lymphedema is a malformation of the lymph vessel system. Secondary lymphedemas can be due to infections, recurrent inflammation, hypoproteinemia, tumors, operations, or irradiation. As a reaction to persistent edema and interstitial macromolecules, fibrosis occurs. Recurrent inflammations of the indurated and edematous tissue are clinically impressive. The massive form of the scrotal lymphedema leads to painful tautness and sexual dysfunction. A concurrent penile edema can cause dysuria. The deformity of the affected extremities and organs not only leads to restriction of mobility but also to psychological stress due to the disfigurement, even as far as to social deprivation. We report on a surgical technique for treating pronounced scrotal edema by resection and neoscrotal reconstruction using ventral pedunculated scrotal skin flaps in cases of congenital hereditary elephantiasis of the Meige type.