Surgery of male genital lymphedema

Incapacitating male genital lymphedema most commonly results from filariasis, which is endemic in the tropical and subtropical countries. However, with the advent of extensive ablative surgical and radiotherapeutic measures against abdominopelvic malignancies, more cases of iatrogenic lymphedema of the genitalia can be expected in other parts of the world as well. Surgical treatment of male genital lymphedema is essentially divided into 1) excision of subcutaneous lymphedematous tissues with genital reconstruction using the remaining skin and 2) complete excision of lymphedema followed by split thickness skin grafting of the denuded phallus. The rationale behind our preference for the latter procedure is discussed with illustrative case profiles and important salient surgical steps are outlined.