Surgical treatment of giant penile and scrotal lymphedema after syphilitic infection. Case report.

Penile and scrotal lymphedema is characterized by an abnormal retention of fluid in the subcutaneous tissue of the penis and scrotum, due to a deficiency in lymphatic drainage, causing edema, pain, dysuria and sexual dysfunction. The present report describes a patient with a giant penile and scrotal lymphedema after syphilitic infection, treated by excision of all the compromised skin and subcutaneous cellular tissue, with primary reconstruction with partial skin autograft and flap rotation. Literature review showed good functional results (erections and ejaculation) with the use of techniques that resected the skin and subcutaneous tissue and reconstructed the penis using skin grafts. This report can help in the differential diagnosis of lymphedema in the external genitalia and presents an aesthetical and functional reconstructive approach, showing the versatility and applicability of the graft and the fasciocutaneous flap of the thigh in this topography.