{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:18:53Z","timestamp":1768436333234,"version":"3.49.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T00:00:00Z","timestamp":1557446400000},"content-version":"vor","delay-in-days":129,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Massive localized lymphedema is an aggressive type of lymphedema that causes great functional impairment for the patient, depriving from one\u2019s basic life activities. The treatment of this type of lesion is eminently surgical, requiring ablative surgery (complete surgical resection of the lesion), but the possible techniques not always provide a good functional result.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>We reported a case of a penoscrotal massive lymphedema treated by our Body Contour Group\/Plastic surgery department of our institute. We performed the resection of the giant penoscrotal lesion, used a posterior scrotal flap for defect\u2019s reconstruction and a split-thickness skin graft for penis\u2019 body reconstruction, closed with Z-plasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Contrary to what the literature says, we prefer to use the split-thickness skin graft to reconstruct the penis\u2019 body in these cases, against local flaps. According to our experience with some similar cases, this technique provides a better functional result once it allows the penis to a better expansion during erection. The key maneuver to avoid contracture of the graft and retraction of the penis is to perform a broken line suture (Z-plasty) in the topography of the median raphe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In cases of penoscrotal massive lymphedema, the treatment\u2019s option with better results is the surgical one. The use of a scrotal flap associated with split-thickness skin graft for penis provides good aesthetic and functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2019.05.022","type":"journal-article","created":{"date-parts":[[2019,5,14]],"date-time":"2019-05-14T11:52:15Z","timestamp":1557834735000},"page":"84-89","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Surgical treatment of a penoscrotal massive localized lymphedema"],"prefix":"10.1097","volume":"59","author":[{"given":"Rodolfo Costa","family":"Lobato","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael Ferreira","family":"Zatz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson Cintra","family":"Junior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel Luiz Antonio","family":"Modolin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Chi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanessa Katiana","family":"Van Dunem Filipe de Almeida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Gemperli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-22-20260114","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00281-012-0346-4","article-title":"Immunopathogenesis of lymphatic filarial disease","volume":"34","author":"Babu","year":"2012","journal-title":"Semin. 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Surg"},{"key":"R14-22-20260114","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/j.eururo.2010.11.020","article-title":"Assessment and follow-up of patency after lymphovenous microsurgery for treatment of secondary lymphedema in external male genital organs","volume":"60","author":"Mukenge","year":"2011","journal-title":"Eur. Urol"},{"key":"R15-22-20260114","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.bjps.2014.10.003","article-title":"Treatment of male genital lymphedema: an integrated concept","volume":"68","author":"Torio-Padron","year":"2015","journal-title":"J. Plast. Reconstr. Aesthet. Surg"},{"key":"R16-22-20260114","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.bjps.2012.06.024","article-title":"Reconstruction of massive localised lymphoedema of the scrotum with a novel fasciocutaneous flap: a rare case presentation and a review of the literature","volume":"66","author":"Champaneria","year":"2013","journal-title":"J. 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Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261219302688?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261219302688?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01612930-201959000-00022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:44:06Z","timestamp":1768398246000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01612930-201959000-00022"}},"subtitle":["Case report"],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":17,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2019.05.022","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}