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Miklós Romics, János Jósvay, Tamás Regőczi and Péter Nyirády
Introduction: Despite the fact that massive scrotal elephantiasis is relatively uncommon in the Western world, the diagnostic and therapeutic know-how is highly important, since the condition has a huge impact on the patients’ quality of life. In endemic territories it is usually an infection that leads to this chronic, benign anomaly; however, in developed countries, more often than not, it is the aftermath of morbid obesity. The treatment algorithm requires extreme caution and sustained cooperation between the patient’s urologist, dermatologist, and plastic surgeon. Our aim is to demonstrate the process with visual aids.
Case description: In our work, we proudly present 5 cases, where gross scrotal elephantiasis was either idiopathic, or it could only be traced back to morbid obesity. All of our patients have been examined by a urologist, a dermatologist, and a plastic surgeon, and most of the operations were performed in the presence of the latter two.
Results: We could resect the redundant tissue in every case without any significant complications, and no relapse has been seen in the long-term follow-up (79-17, avg 45.4 months). Also, no major complications have occurred either, thanks to the thorough preparation, and pre-operative and intraoperative management.
Discussion: Since morbid obesity is more common today in the Western world than ever before, adiposity-related scrotal elephantiasis is also becoming more frequent in our time.
Conclusion: It is advised to prepare ourselves with the necessary knowledge of diagnosing and treating scrotal elephantiasis.