Reconstruction of Massive Localized Lymphedema of the Scrotum: Results, Complications and Quality of Life Improvements

Abstract Objective To review the surgical technique, outcomes and complications of surgical excision of massive localized lymphedema of the scrotum, and to determine changes in weight and quality of life after excision. Materials and 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 quality of life data were recorded. Results Eleven patients were included with a mean follow-up of 26 months after surgery. The mean pre-operative body mass index was 60 and the mean weight of resected tissue was 21kg. No patient required an orchiectomy for completion of the resection. Skin grafting was performed in one 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 + 5.2kg). 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 61kg (134lbs). Short-term wound complications are common, but subjective quality of life 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.