ELEPHANTIASIS OF THE SCROTUM

The surgical technique for elephantiasis of the scrotum is more challenging since you should preserve the penis and the testes which are hidden in the edematous elephantiasis tissue.

 The patient is placed in lithotomy position

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Make a circular cut around the opening where the urine comes and isolate the redundant penile skin and the shaft of the penis by sharp dissection

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Identify both testes and spermatic cord. Isolate these structures and have the assistant elevate and protect them during the rest of the procedure

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Cut away all edematous elephantiasis tissue while the vital structures are elevated and protected by the assistant.

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Make downward traction of the suprapubic skin. Make a circular hole for the penis, roll back the penile skin and suture it to the border of that hole.

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Suture the lower border of the suprapubic skin flap to the perineal skin covering the testes. It is prudent to leave tube drains before skin closure

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