{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:53:55Z","timestamp":1787032435536,"version":"build-2736575974"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":814,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T00:00:00Z","timestamp":1579046400000},"content-version":"tdm","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-aps.org"],"crossmark-restriction":true},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.<\/jats:p>","DOI":"10.5999\/aps.2019.01123","type":"journal-article","created":{"date-parts":[[2020,1,19]],"date-time":"2020-01-19T19:54:42Z","timestamp":1579463682000},"page":"3-8","update-policy":"https:\/\/doi.org\/10.5999\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Surgical management of male genital lymphedema: A systematic review"],"prefix":"10.1055","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6306-3581","authenticated-orcid":false,"given":"Indri","family":"Aulia","sequence":"additional","affiliation":[{"name":"External Genitalia Section, Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0219-641X","authenticated-orcid":false,"given":"Eva Chintia","family":"Yessica","sequence":"additional","affiliation":[{"name":"External Genitalia Section, Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1097\/01.sap.0000257149.42922.7e","article-title":"Lymphedema: a comprehensive review","volume":"59","author":"AG Warren","year":"2007","journal-title":"Ann Plast Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"408","DOI":"10.4103\/0019-5154.117340","article-title":"Transient idiopathic primary penoscrotal edema","volume":"58","author":"SA Namir","year":"2013","journal-title":"Indian J Dermatol"},{"key":"ref3","first-page":"519","article-title":"Management of secondary lymphoedema","volume":"20","author":"TW Chiu","year":"2014","journal-title":"Hong Kong Med J"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/micr.1920060107","article-title":"Microlymphaticovenous anastomosis for treating scrotal elephantiasis","volume":"6","author":"GK Huang","year":"1985","journal-title":"Microsurgery"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1002\/micr.20737","article-title":"Microsurgery for lymphedema: clinical research and long-term results","volume":"30","author":"C Campisi","year":"2010","journal-title":"Microsurgery"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1003e","DOI":"10.1097\/PRS.0000000000003218","article-title":"Current concepts in the surgical management of lymphedema","volume":"139","author":"TA Kung","year":"2017","journal-title":"Plast Reconstr Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S0094-1298(20)30602-7","article-title":"Lymphedema","volume":"14","author":"MR Kobayashi","year":"1987","journal-title":"Clin Plast Surg"},{"key":"ref8","first-page":"14","article-title":"Modified Charles operation for primary fibrosclerotic lymphedema","volume":"27","author":"ME Mavili","year":"1994","journal-title":"Lymphology"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological index for non-randomized studies (MINORS): development and validation of a new instrument","volume":"73","author":"K Slim","year":"2003","journal-title":"ANZ J Surg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1002\/micr.30331","article-title":"Lymphovenous anastomosis and debulking procedure for treatment of combined severe lower extremity and genital lymphedema: a case report","volume":"38","author":"MF Scaglioni","year":"2018","journal-title":"Microsurgery"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"57","DOI":"10.4322\/acr.2016.026","article-title":"Giant lymphedema of the penis and scrotum: a case report","volume":"6","author":"F Vives","year":"2016","journal-title":"Autops Case Rep"},{"key":"ref12","first-page":"ic15","article-title":"Scrotal lymphedema","volume":"11","author":"C Pastor","year":"2011","journal-title":"Eplasty"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/j.1464-410X.2008.07559.x","article-title":"The management of genital lymphoedema","volume":"102","author":"G Garaffa","year":"2008","journal-title":"BJU Int"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/01.sap.0000258448.17867.20","article-title":"Surgical management of scrotal lymphedema using local flaps","volume":"59","author":"TJ Halperin","year":"2007","journal-title":"Ann Plast Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/j.bjps.2014.07.031","article-title":"Surgical reduction of scrotal massive localized lymphedema (MLL) in obesity","volume":"67","author":"JA Machol","year":"2014","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.ijscr.2012.03.005","article-title":"Giant scrotal lymphoedema: a case report","volume":"3","author":"P Thejeswi","year":"2012","journal-title":"Int J Surg Case Rep"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jvscit.2019.02.002","article-title":"Surgical management of giant scrotal lymphedema in morbidly obese patient with trisomy 21","volume":"5","author":"YM Elkiran","year":"2019","journal-title":"J Vasc Surg Cases Innov Tech"},{"key":"ref18","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":"6","author":"N Torio-Padron","year":"2015","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1590\/S1807-59322006000400003","article-title":"Surgical treatment of lymphedema of the penis and scrotum","volume":"61","author":"M Modolin","year":"2006","journal-title":"Clinics (Sao Paulo)"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.urology.2016.09.064","article-title":"Surgical reconstruction of giant penoscrotal lymphedema in sub-Saharan Africa","volume":"112","author":"AA Salako","year":"2018","journal-title":"Urology"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1002\/micr.20426","article-title":"Secondary scrotal lymphedema: a novel microsurgical approach","volume":"27","author":"S Mukenge","year":"2007","journal-title":"Microsurgery"},{"key":"ref22","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":"SM Mukenge","year":"2011","journal-title":"Eur Urol"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-aps.org\/upload\/pdf\/aps-2019-01123.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-aps.org\/journal\/view.php?doi=10.5999\/aps.2019.01123","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.5999\/aps.2019.01123.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T04:08:19Z","timestamp":1705550899000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.5999\/aps.2019.01123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":22,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2022,3,25]]},"published-print":{"date-parts":[[2020,1]]}},"URL":"https:\/\/doi.org\/10.5999\/aps.2019.01123","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"2019-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-15","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-15","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}