{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:20:00Z","timestamp":1761664800787,"version":"3.41.2"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite various therapeutic options, evidence remains limited on optimal medical or surgical management of genital lymphedema in male patients. This study evaluated postoperative outcomes of male patients undergoing a combination of the Charles Procedure and lymphatic superficial circumflex iliac artery perforator (SCIP) flap reconstruction for penoscrotal lymphedema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Male patients with International Society of Lymphology stage III genital lymphedema involving the scrotum and penis were included. All underwent the Charles Procedure combined with bilateral pedicled lymphatic SCIP flap transfer. Data on demographics, indocyanine green lymphography and lymphoscintigraphy findings, symptom duration, pre\u2010 and postoperative duration of complex decongestive therapy (CDT), estimated blood loss, surgical time, length of stay, and complications were analyzed. Genital Lymphedema Score (GLS) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight patients were included. The mean age was 43\u2009years, and BMI was 28.4\u2009kg\/m<jats:sup>2<\/jats:sup>. The mean follow\u2010up was 34\u2009months. Secondary genital lymphedema was the most common type (75%). The average weight of resected lymphedematous tissue was 1772.7\u2009g. The mean estimated blood loss was 200.6\u2009mL, and mean surgical time was 160\u2009min. Two patients (25%) experienced postoperative complications: one developed seroma formation and dehiscence, while the other had partial skin graft loss. No cases of lymphedema recurrence were observed. Sexual dysfunction improved in all patients (87.5% versus 0%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). GLS scores significantly decreased after the procedure (6.6 versus 0.6; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combined Charles Procedure and bilateral lymphatic SCIP flap transfer is an effective surgical approach for penoscrotal lymphedema, optimizing postoperative outcomes with a low complication and recurrence rate.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.70075","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T13:28:41Z","timestamp":1748698121000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Management of Genital Lymphedema Using the Combined Charles' Procedure and Lymphatic Superficial Circumflex Iliac Artery Perforator Flap Transfer (<scp>CHASCIP<\/scp>)"],"prefix":"10.1002","volume":"45","author":[{"given":"Pedro","family":"Ciudad","sequence":"first","affiliation":[{"name":"Ciruesthetic Clinic, Reconstructive and Burn Surgery  Lima Peru"},{"name":"Department of Plastic, Reconstructive and Burn Surgery Arzobispo Loayza National Hospital  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8982-1950","authenticated-orcid":false,"given":"Joseph M.","family":"Escand\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Surgery Wyckoff Heights Medical Center  New York City New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Escand\u00f3n","sequence":"additional","affiliation":[{"name":"School of Medicine Universidad El Bosque  Bogot\u00e1 D.C. Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horacio F.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School  Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar J.","family":"Manrique","sequence":"additional","affiliation":[{"name":"Austin\u2010Weston Center for Cosmetic Surgery  Reston Virginia 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