A 43-year-old man from Panama was forced to have his scrotum removed and the entire region reconstructed after he suffered swelling so severe that his scrotum hung below his knees and literally started to rot.
According to a case study in the Urology Case Reports, the patient suffered from severe lymphoedema of the scrotum over the period of 30 years. He was unable to walk or carry out day-to-day tasks.
Blockage of the lymph glands
When he presented to a hospital in Panama, he had a fever and CT scans of his abdomen and bowel revealed a massive hernia, which was left untreated and led to restriction of fluids, which caused the swelling in the area, which was diagnosed as lymphoedema.
Lymphoedema is the swelling in a limb caused by a blockage of the lymph glands that are left unable to drain lymph fluid from a certain area. This is usually caused by cancer, infections or inflammation, and in this case the massive hernia was the culprit.
The skin of the patient’s scrotum was thickened and started to show signs of Fournier’s gangrene, which can be life-threatening. Two open wounds on the scrotum emitted foul-smelling pus. This increased the man’s risk of sepsis and doctors made the decision to remove the infected tissue and reconstruct the area.
Penis remained intact
The swelling measured 30.2cm x 24.4cm x 13.1cm.
As the surgical team removed the infected skin and tissue, further open wounds were found under the skin. The swelling was so severe that the man’s penis was buried inside the swollen scrotum. It took two surgical procedures to remove all of the dead flesh.
The testicles were removed, but the patient’s penis remained intact and a skin graft was done.
The patient received antibiotics through IV for a further five days in hospital, then spent a further four weeks in a rehabilitation centre, and is on his way to recovery, according to the report.
Image credit: iStock