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[Lymphedema of male external genitalia: a retrospective study of 33 cases]
1Unité de Lymphologie, Hôpital Cognacq-Jay, Site Broussais, Paris. stephane.vignes@hopital-cognacq-jay.fr
Insights
Male external genitalia lymphedema causes discomfort and complications. Surgical treatment, including excision, is effective for symptomatic cases, offering good outcomes in a majority of patients.
Area of Science:
- Urology
- Lymphology
- Surgical Oncology
Context:
- Male external genitalia lymphedema is a rare condition.
- Characterized by swelling and potential complications like infections and impaired urination.
- Can be primary (congenital or idiopathic) or secondary to various cancers and treatments.
Purpose:
- To describe the characteristics and treatment of male external genitalia lymphedema.
- To evaluate the outcomes of surgical interventions for this condition.
Summary:
- A retrospective study of 33 patients (17 primary, 16 secondary) with male external genitalia lymphedema.
- Common symptoms include genital heaviness, lower limb lymphedema, and hydrocele.
- Surgical treatment (circumcision, cutaneous excision) was performed in 17 patients with good results.
Impact:
- Highlights the significant discomfort and complications associated with genital lymphedema.
- Establishes surgical intervention as a primary treatment modality.
- Provides evidence for the efficacy of surgical management in improving patient outcomes.
Introduction:
The aim of this retrospective study was to describe the main characteristics and treatment of male external genitalia lymphedema.
Patients And Methods:
From 1987 to 2003, all patients seen in a single hospital for lymphedema of male external genitalia were included. For each patient, the following characteristics were recorded: primary or secondary lymphedema, cause of secondary form, date of onset of lymphedema, associated lower limb lymphedema, clinical signs, and complications. In the primary forms, lower limb lymphoscintigraphy was performed. Specific surgery was proposed in all cases of symptomatic lymphedema (circumcision, scrotum and/or penile cutaneous excision).
Results:
Thirty-three patients with lymphedema of external genitalia (17 primary, 16 secondary) were recruited. Two primary lymphedema were congenital, one isolated. Mean age +/- SD of the onset of the 15 other primary genital lymphedema was 23.4 +/- 17.5 years, always after the appearance of lower limb lymphedema. Sixteen men had secondary lymphedema (bladder, prostate, or rectum cancer, Hodgkin or non-Hodgkin lymphoma, aorto-bifemoral bypass grafting, biopsy or curretage of inguinal nodes). Secondary genitalia lymphedema was not associated with lower limb lymphedema in two cases and, in the others it occurred 66 +/- 122 months after (n=11), at the same time (n=2) or before lower limb lymphedema (n=1). Clinically, we noted genitalia heaviness (n=31), lower limb lymphedema (n=30), vaginal hydrocele (n=13), impaired miction due to prepucial swelling (n=10), leakage of lymphatic fluid (n=10). Lower limb lymphedema was complicated by at least one erysipelas (n=20), spreading to the external genitalia (n=4). In primary forms, lymphoscintigraphy showed ipsilateral hypoplasia of inguinal nodes in lower limb lymphedema (n=14) and/or external genitalia backflow (n=7). Surgical treatment was performed in 17 cases (11 primary, 6 secondary) with good results after 21 months' median follow up (1 month-10 years). Two patients died of cancer. One secondary lymphedema improved spontaneously and one disappeared after withdrawal of lower limb pneumatic compression.
Discussion:
Lymphedema of external genitalia is responsible for discomfort and local complications. Surgical treatment is the main procedure of this disorder.
