Glickman Urological & Kidney Institute Outcomes

Genital lymphedema is another condition that often severely limits patients in terms of activities of daily living (ADL) and quality of life. The institute recently reviewed a series of 39 patients undergoing surgical treatment for this condition over a 20-year period. Most cases were idiopathic or post-surgical; smaller numbers had hidradenitis or were congenital. The operative procedure involved resection of the lymphedematous mass and reconstruction of the penis and scrotum using either scrotal flaps or a skin graft (usually on the penis). Mean BMI was 44±14 kg, and resected weight of tissue assessed in pathology was 8±11 kg. The penile skin did not require resection in 7 (18%) of patients. Skin graft to the penis was required in 18 (46%) cases, with the remainder undergoing penile shaft coverage using a scrotal flap in association with complex scrotoplasty. As expected in this patient group, 28% of patients had wound complications primarily of separation requiring packing and local care. Only 4 patients required secondary surgical procedures. Nineteen (49%) patients were available for a phone interview. Patient Global Impression of Change scores on a scale of 1-5 (1=much worse and 5=much better) were generally a mean of 4 for domains including overall satisfaction, pain, physical appearance, and ADL.