Penoscrotal elephantiasis: A severe form of genital lymphedema

Penoscrotal lymphedema is a manifestation of disrupted lymphatic drainage, causing a significant increase in scrotal volume. impacting both aesthetics and quality of life. Elephantiasis, classified as stage III by the International Society of Lymphology, represents the advanced stage of scrotal lymphedema, often linked to parasitic diseases. The diagnosis is clinical, and the treatment involves mass excision. The lymphatic reconstruction is an innovative therapeutic approach that improves postoperative results and better quality of life. In this case report, we present the case of massive genital elephantiasis managed surgically, and we will focus on surgical techniques and reconstructive approaches. •Genital elephantiasis is a severe scrotal swelling affecting the patient's quality of life sexually and psychologically.•Elephantiasis is classified as stage III by International Society of Lymphology.•Parasitic disease (such as filariasis) is the most common cause, causing a lymphatic obstruction.•Radical resection associated to a lymphatic reconstruction achieves satisfactory results and improve quality of life.