[Operative management of penoscrotal elephantiasis]

Enormous oedema of the male genitals, such as penoscrotal elephantiasis, is a very rare condition. It is usually a result of recurrent inflammation, trauma or malignancy, although the main cause is lymphatic filariasis. Furthermore, it is a challenging condition for both patient as well as the attending healthcare team. By elongation of the lymphatic channels, local oedema is initially created. In the further course, through fibrosis and thus deterioration of the lymphatic drainage, recurrent infections with irreversible elephantiac hard swelling and skin changes are evident. Depending upon the clinical stage, conservative or surgical treatment are suggested. Unfortunately, up to date, no evidence-based therapeutic protocol exists. Interdisciplinary cooperation among doctors, physiotherapists with active cooperation of the patient decide the success of the therapeutic outcome.