Peno-Scrotal Elephantiasis: An Observation and Literature Review

Scrotal elephantiasis is a rare pathology Peno-scrotal elephantiasis (scrotal lymphedema) is most common in endemic filarian areas. Outside these areas this pathology remains quite rare. We report a case of primitive peno-scrotal elephantiasis. A 60-year-old patient with no significant pathological history, who had a significant increase of the bursa volume that had been evolving for years. The clinical examination found a bursary 46 cm in diameter with thickened skin and a penis buried in a glove finger. Exploration of the vascular axis of the lower limbs was normal. Peri-scrotal MRI noted significant infiltration of inflammatory-looking scrotal tunics, but found no obstructive cause. The patient was treated by a complete surgical resection of the pathological tissue and a peno-scrotal reconstruction. The evolution was marked by a progressive healing of the surgical wound, the patient was reviewed several times to assess the benefit of the treatment, he noted a satisfaction of the surgery allowing a good functional and aesthetic result. The aim of this case report is to present a specific management of a peno-scrotal elephantiasis in our hospital and to compare it with the review of literature on surgical management of this pathology. This condition is uncommon and challenging to manage for most urologists.