{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:18:44Z","timestamp":1786979924207,"version":"build-2736575974"},"reference-count":77,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,8,29]],"date-time":"2015-08-29T00:00:00Z","timestamp":1440806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,8,29]],"date-time":"2015-08-29T00:00:00Z","timestamp":1440806400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Genital manifestations of lymphatic filariasis (genital LF) are a significant cause of disfigurement and disability in the developing world. Surgery is the standard treatment; however, definitive publications are lacking and best practice remains unclear. An exhaustive search strategy using keyword and subject headings was applied to Medline, EMBASE, Web of Science, CINAHL, and Scopus. Additionally citation lists, Google and Google Scholar, archives of relevant journals and websites were searched systematically. Studies with data on one or more human patient(s) who underwent surgery for genital LF were included. Articles were screened and data extracted by the first author with data verification by the second author. Fifty\u2010seven studies were included: 18 series of ablative surgery, four series of non\u2010ablative surgery and 35 case reports. Poor study quality, heterogeneous case definitions, lack of severity grading and limited follow\u2010up precluded meta\u2010analysis. Two series of simple hydrocelectomies performed in resource\u2010limited settings reported early complication rates of 3.0\u20133.5 % using eversion and 5\u20137 % using excision, with recurrence of 7 % and 3\u20135 %, respectively. Complications were minimal for single\u2010surgeon series and greater (12\u201318 %) when scrotal reconstruction was performed. There is little useful evidence for lymphatic bypass procedures in genital LF. Under\u2010recognition of atypical manifestation of genital LF leads to potentially unnecessary surgeries. Surgery for genital LF is safe in resource\u2010limited settings; however, more well\u2010designed studies with better follow\u2010up are needed. Research priorities include validation of case definitions and severity grading systems, and solutions to improve post\u2010operative follow\u2010up in resource\u2010limited settings.<\/jats:p>","DOI":"10.1007\/s00268-015-3220-4","type":"journal-article","created":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T11:44:13Z","timestamp":1440762253000},"page":"2885-2899","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Surgical Treatment of Genital Manifestations of Lymphatic Filariasis: A Systematic Review"],"prefix":"10.1002","volume":"39","author":[{"given":"Kah Heng Alexander","family":"Lim","sequence":"first","affiliation":[{"name":"College of Public Health, Medical and Veterinary Sciences James Cook University Townsville QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Speare","sequence":"additional","affiliation":[{"name":"College of Public Health, Medical and Veterinary Sciences James Cook University Townsville QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Thomas","sequence":"additional","affiliation":[{"name":"The Carter Center One Copenhill Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Graves","sequence":"additional","affiliation":[{"name":"College of Public Health, Medical and Veterinary Sciences James Cook University Townsville QLD Australia"},{"name":"JCU\/WHO Collaborating Centre for LF, STH and Other NTDs, Division of Tropical Health and Medicine James Cook University Cairns QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,29]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003319"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475\u20102883\u20106\u20102"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002865"},{"key":"e_1_2_10_5_2","unstructured":"World Health Organization(2002)Report of an informal consultation on surgical approaches to the urogenital manifestations of lymphatic filariasis. WHO\/CDS\/CPE\/CEE\/2002.33"},{"key":"e_1_2_10_6_2","first-page":"153","article-title":"Surgical challenges in lymphatic filariasis","volume":"10","author":"Vries CR","year":"2004","journal-title":"Afr J Urol"},{"key":"e_1_2_10_7_2","first-page":"125","volume-title":"An introduction to systematic reviews","author":"Gough D","year":"2012"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445\u20102197.2003.02748.x"},{"key":"e_1_2_10_9_2","first-page":"24","article-title":"Surgical management of morbidity due to lymphatic filariasis: the usefulness of a standardized international clinical classification of hydroceles","volume":"29","author":"Capuano GP","year":"2012","journal-title":"Trop Biomed"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109610(85)80156\u20102"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2010.09.008"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1807\u201059322006000400003"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2010.10.026"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2009.80.447"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000695"},{"key":"e_1_2_10_16_2","first-page":"73","article-title":"Treatment of tropical hydrocele: a study of 273 cases","volume":"4","author":"Fasana F","year":"1982","journal-title":"Medicom"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464\u2010410X.1995.tb07677.x"},{"key":"e_1_2_10_18_2","first-page":"84","article-title":"The surgical technique and operative treatment of elephantiasis of the generative organs based on a series of 140 consecutive successful cases","volume":"36","author":"Charles RH","year":"1901","journal-title":"Ind Med Gaz"},{"key":"e_1_2_10_19_2","first-page":"315","article-title":"Scrotal elephantiasis: about seven operated cases","volume":"97","author":"Bouya PA","year":"2004","journal-title":"Bull Soc Pathol Exot"},{"key":"e_1_2_10_20_2","first-page":"368","article-title":"Surgical treatment of filarial scrotum and penis","volume":"19","author":"Venkateswaran CH","year":"1950","journal-title":"J Indian Med Assoc"},{"key":"e_1_2_10_21_2","first-page":"358","article-title":"Surgical treatment of huge elephantiasis of scrotum","volume":"18","author":"Zhou ZY","year":"1980","journal-title":"Chin J Surg"},{"key":"e_1_2_10_22_2","first-page":"98","article-title":"Filarial lymphoedema","volume":"12","author":"Kini MG","year":"1950","journal-title":"Indian J Surg"},{"key":"e_1_2_10_23_2","first-page":"51","article-title":"Efficacy of surgical treatment of hydrocele in 167 cases with filariasis bancrofti","volume":"18","author":"Tao ZH","year":"2000","journal-title":"Chin J Parasitol Parasit Dis"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)60508-1"},{"key":"e_1_2_10_25_2","first-page":"481","article-title":"Surgical treatment of elephantiasis of male genitalia","volume":"46","author":"Khanna NN","year":"1970","journal-title":"Plast Reconstr Surg"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM194808052390604"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1995\u20107645(11)60062\u2010X"},{"key":"e_1_2_10_28_2","first-page":"189","article-title":"Epididymal filariasis in a child","volume":"25","author":"Al\u2010Hindi S","year":"2003","journal-title":"Bahrain Med Bull"},{"key":"e_1_2_10_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2014.02.007"},{"key":"e_1_2_10_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107819\u20109\u201020"},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.4103\/0019\u20105154.74563"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)59444-6"},{"key":"e_1_2_10_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/00034983.1981.11687446"},{"key":"e_1_2_10_34_2","first-page":"429","article-title":"Microlymphaticovenous anastomosis for lymphedema of external genitalia in females","volume":"162","author":"Gong\u2010Kang H","year":"1986","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_10_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.1920060107"},{"key":"e_1_2_10_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637\u2010198910000\u201000005"},{"key":"e_1_2_10_37_2","first-page":"305","article-title":"Lymphscrotum of filarial origin. Surgical treatment by lymphatico\u2010venous fistula","volume":"32","author":"Arrighi E","year":"1972","journal-title":"Med Trop"},{"key":"e_1_2_10_38_2","first-page":"347","article-title":"Successful removal of an elephantiasis scrotum weighing 70 pounds (35srs.) in a very poor surgical risk case","volume":"84","author":"Das N","year":"1949","journal-title":"Indian Med Gaz"},{"key":"e_1_2_10_39_2","first-page":"521","article-title":"Elephantiasis of the penis","volume":"25","author":"Bourrel P","year":"1965","journal-title":"Med Trop"},{"key":"e_1_2_10_40_2","first-page":"191","article-title":"Enormous elephantiasis of the scrotum","volume":"14","author":"Holubec K","year":"1972","journal-title":"Acta Chir Plast"},{"key":"e_1_2_10_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464\u2010410X.1976.tb06672.x"},{"key":"e_1_2_10_42_2","first-page":"891","article-title":"Filarial elephantiasis of penis: a crippling manifestation","volume":"44","author":"Rakesh K","year":"1991","journal-title":"Arch Esp Urol"},{"key":"e_1_2_10_43_2","first-page":"201","article-title":"Giant penoscrotal filariasis","volume":"17","author":"Gafur MA","year":"2008","journal-title":"Mymensingh Med J"},{"key":"e_1_2_10_44_2","unstructured":"JeudyJ(2010)Surgical repair of a giant scrotal elephantiasis BJUI case reports BJUI.org"},{"key":"e_1_2_10_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2012.03.005"},{"key":"e_1_2_10_46_2","doi-asserted-by":"publisher","DOI":"10.5455\/ijmsph.2013.2.153\u2010155"},{"key":"e_1_2_10_47_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010008\u20100628\u20101"},{"key":"e_1_2_10_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00238\u2010007\u20100208\u20109"},{"key":"e_1_2_10_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010197110000\u201000027"},{"key":"e_1_2_10_50_2","first-page":"178","article-title":"Giant vulval filariasis: an uncommon problem in endemic region","volume":"8","author":"Rathi S","year":"2011","journal-title":"Urol J"},{"key":"e_1_2_10_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752\u20101947\u20102\u2010321"},{"key":"e_1_2_10_52_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010\u2010013\u20100443\u2010x"},{"key":"e_1_2_10_53_2","first-page":"1868","article-title":"Lymphatic filariasis presenting as paratesticular tumour\u07dda case report","volume":"5","author":"Raman RT","year":"2014","journal-title":"Res J Pharm Biol Chem Sci"},{"key":"e_1_2_10_54_2","first-page":"413","article-title":"Rarer surgical aspects of filariasis","volume":"41","author":"Desouza LJ","year":"1964","journal-title":"East Afr Med J"},{"key":"e_1_2_10_55_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.1994.tb01753.x"},{"issue":"146","key":"e_1_2_10_56_2","first-page":"158","article-title":"The characteristics and experiences in the treatment of the hugh scrotal and penile elephantiasis","volume":"2","author":"Wang QR","year":"1986","journal-title":"Chin J Plast Surg Burns"},{"key":"e_1_2_10_57_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.1870230911"},{"key":"e_1_2_10_58_2","first-page":"128","article-title":"Scrotal elephantiasis: a first case report from Bahrain","volume":"30","author":"Al\u2010Sindi K","year":"2008","journal-title":"Bahrain Med Bull"},{"key":"e_1_2_10_59_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.2237.1262"},{"key":"e_1_2_10_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090\u20104295(96)00221\u2010X"},{"key":"e_1_2_10_61_2","doi-asserted-by":"publisher","DOI":"10.1177\/039156031007700211"},{"key":"e_1_2_10_62_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2011.tb03154.x"},{"key":"e_1_2_10_63_2","first-page":"765","article-title":"Inflammatory nodule of the right spermatic cord due to Filaria bancrofti","volume":"99","author":"Lenczner MM","year":"1968","journal-title":"Can Med Assoc J"},{"key":"e_1_2_10_64_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001200050072"},{"key":"e_1_2_10_65_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024479402814"},{"key":"e_1_2_10_66_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756\u20103305\u20107\u20101"},{"key":"e_1_2_10_67_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730131"},{"key":"e_1_2_10_68_2","first-page":"161","article-title":"Role of filariasis in the aetiology of idiopathic hydroceles","volume":"44","author":"Dedhia CN","year":"1982","journal-title":"Indian J Surg"},{"key":"e_1_2_10_69_2","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.000112"},{"key":"e_1_2_10_70_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001479"},{"key":"e_1_2_10_71_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/171.3.755"},{"key":"e_1_2_10_72_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_2_10_73_2","first-page":"Cd009735","article-title":"Aspiration and sclerotherapy versus hydrocoelectomy for treating hydrocoeles","volume":"11","author":"Shakiba B","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)60320\u20102"},{"key":"e_1_2_10_75_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464\u2010410X.2008.07559.x"},{"key":"e_1_2_10_76_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2014.10.003"},{"key":"e_1_2_10_77_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2013.02.087"},{"key":"e_1_2_10_78_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0001\u2010706X(01)00159\u20100"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-015-3220-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-015-3220-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-015-3220-4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T11:32:16Z","timestamp":1704886336000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-015-3220-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,29]]},"references-count":77,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1007\/s00268-015-3220-4"],"URL":"https:\/\/doi.org\/10.1007\/s00268-015-3220-4","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,29]]}}}