Eric Wisenbaugh1, Dena Moskowitz1, Joel Gelman2. 1. Department of Urology, University of California-Irvine, Irvine, CA. 2. Department of Urology, University of California-Irvine, Irvine, CA. Electronic address: jgelman@uci.edu.
Abstract
OBJECTIVE: To review the surgical technique, outcomes, and complications of surgical excision of massive localized lymphedema (MLL) of the scrotum, and to determine changes in weight and quality of life (QOL) after excision. METHODS: A retrospective review was performed for all patients who have undergone excision of MLL of the scrotum at our institution between 2008 and 2014. Standard baseline characteristics, complications, pre- and postoperative weight, and QOL data were recorded. RESULTS: Eleven patients were included, with a mean follow-up of 26 months after surgery. The mean preoperative body mass index was 60, and the mean weight of resected tissue was 21 kg. No patient required an orchiectomy for completion of the resection. Skin grafting was performed in 1 patient, and the rest were closed primarily. Wound complications were common but generally managed successfully with local wound care. At the time of most recent follow-up, most patients had actually gained weight since surgery (mean weight change of +5.2 kg). However, QOL scores improved across all domains, and overall QOL improved from a mean of 1.3 preoperatively to 7.7 postoperatively (where 1 is poor, and 10 is excellent). CONCLUSION: Surgical treatment of MLL of the scrotum can be performed successfully for masses even up to 61 kg (134 lbs). Short-term wound complications are common, but subjective QOL scores improve dramatically. Despite expectations, most patients gained weight after mass removal, which indicates that they would benefit from a comprehensive weight loss plan that includes, but is not limited to, scrotal surgery.
OBJECTIVE: To review the surgical technique, outcomes, and complications of surgical excision of massive localized lymphedema (MLL) of the scrotum, and to determine changes in weight and quality of life (QOL) after excision. METHODS: A retrospective review was performed for all patients who have undergone excision of MLL of the scrotum at our institution between 2008 and 2014. Standard baseline characteristics, complications, pre- and postoperative weight, and QOL data were recorded. RESULTS: Eleven patients were included, with a mean follow-up of 26 months after surgery. The mean preoperative body mass index was 60, and the mean weight of resected tissue was 21 kg. No patient required an orchiectomy for completion of the resection. Skin grafting was performed in 1 patient, and the rest were closed primarily. Wound complications were common but generally managed successfully with local wound care. At the time of most recent follow-up, most patients had actually gained weight since surgery (mean weight change of +5.2 kg). However, QOL scores improved across all domains, and overall QOL improved from a mean of 1.3 preoperatively to 7.7 postoperatively (where 1 is poor, and 10 is excellent). CONCLUSION: Surgical treatment of MLL of the scrotum can be performed successfully for masses even up to 61 kg (134 lbs). Short-term wound complications are common, but subjective QOL scores improve dramatically. Despite expectations, most patients gained weight after mass removal, which indicates that they would benefit from a comprehensive weight loss plan that includes, but is not limited to, scrotal surgery.
Authors: Mélanie Aubé; Michael Chua; Jessica DeLong; Kurt McCammon; Jeremy Tonkin; David Gilbert; Ramón Virasoro Journal: Int Urol Nephrol Date: 2019-12-03 Impact factor: 2.370