Scrotal lymphedema is a rare disease, caused by obstruction of the lymphatic vessels draining into the scrotum, and may be induced by malignant lymphoma.
A 27-year-old male, who was treated for Hodgkin's lymphoma, presented with scrotal swelling for 3 years. We observed huge scrotal swelling with extension to the suprapubic region and lower right limb, a significantly thickened scrotal wall, and nonpalpable testes. The patient underwent scrotal lymphedema excision followed by surgical scrotal and penile reconstruction.
Treatment of scrotal lymphedema is challenging. However, we were satisfied with our surgical result. Our patient experienced both physical and psychological improvements.
Background
Approximately 2–10% of patients with varicocele complain of pain. Varicocelectomy for testicular pain is a surgical choice when conservative therapy fails to relieve the pain. Different variables have been reported as prognostic factors for pain relief following varicocele ligation. Moreover, the success rate of varicocelectomy for testicular pain has varied among studies. This retrospective study aimed to investigate the predictors and success rate of microscopic subinguinal varicocelectomy performed for the treatment of painful varicocele.
Results
Among the 132 patients, 83.3% reported pain relief. A significant association was identified between varicocelectomy for unilateral testicular pain and pain resolution (P < 0.0001); no other factors were predictors of pain relief.
Conclusions
Microscopic subinguinal varicocelectomy for testicular pain is an effective surgical alternative. Varicocelectomy for unilateral testicular pain may predict postoperative pain relief in appropriately selected patients.
Background: The Inflatable penile prostheses (IPP) are used as definitive treatment for severe erectile dysfunction. Removal of an IPP can be challenging, especially for the non-andrologists and junior urologists. The classic penoscrotal incision for explanation can disrupt anatomy, which increases the risk of complications and makes future re-implantation difficult. This article aims to describe a simple surgical method for the removal of IPP, which avoids the penoscrotal incision and reduces the risk of urethral damage and additional fibrosis. Material and methods: Between November 2015 and February 2019, 15 patients underwent IPP removal using the same technique. Multiple incisions were performed directly over each component of the IPP for their removal. Four incisions of 2 cm each were made at the following sites: one incision on both sides of the ventral base of the penis, one inguinal incision, and one scrotal incision. Each incision provides direct access to one component of the IPP (cylinders, reservoir, and pump). Results: The mean duration of the surgery was 41 min (between 35 and 48 min). All procedures were completed successfully with a smooth course. None of the patients had any residual component of the IPP at the time of surgery. Neither complications (urethral or intestinal injury) nor excessive bleeding (> 100 mL) were documented in all patients. Conclusion: Our approach provides direct exposure of all components of the IPP. It reduces the risk of urethral iatrogenic injury and the local fibrosis (which is greater with the penoscrotal incision) that may impair future reinsertion of IPP. It is simple, safe, reproducible and easy to be performed by junior or unexperienced urologists in urgent cases. Resume: Contexte: Les implants péniens hydrauliques (IPH) constituent le traitement définitif des dysfonctions érectiles. Le retrait de ces prothèses peut être difficile, surtout pour les jeunes urologues. L'incision classique pénoscrotale est. peu anatomique. Elle est. associée à un risque de plaies urétrales et de fibrose pouvant limiter l'insertion ultérieure de nouvelles prothèses. Nous présentons dans cet article une méthode alternative simple pour le retrait des IPH qui permet d'éviter l'incision péno-scrotale et les risques qui s'y associent. Matériel et Méthodes: Entre novembre 2015 et février 2019, 15 patients ont été opérés pour extraction d'IPH infectés, en utilisant la même technique chirurgicale. Une incision de 2 cm est. réalisée en face de chaque élément de l'IPH pour permettre son extraction: une incision scrotale, une autre inguinale et une de chaque côté de la base ventrale du pénis.
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