Aim:Genital lymphoedema(GL)is a chronic and debilitating disease,which can severely affect the patient’s quality of life with significant socio-economic impact.Nowadays,no gold standard algorithm exists for GL from d...Aim:Genital lymphoedema(GL)is a chronic and debilitating disease,which can severely affect the patient’s quality of life with significant socio-economic impact.Nowadays,no gold standard algorithm exists for GL from diagnosis to treatment.This study proposes our therapeutic flowchart based on the three senior consultants’experience in lymphatic surgery.Methods:A retrospective investigation was conducted on a prospectively maintained database(2018-2022).Inclusion criteria involved all patients who underwent surgical procedures for treating GL in three plastic surgery departments(Lausanne,Bari,and Genova).Outcomes were assessed in terms of oedema reduction,stage regression,and functional reported outcomes.Results:16 patients with GL were included:50%underwent debulking surgery,18.8%microsurgery,and 31.2%debulking+microsurgery.We recorded a significant regression of the GL stage:62.5%shifted from stage II/III to postoperative stage I.Similarly,we found an infection recurrency resolution in 50%,a scrotal oedema reduction in 62.5%,and a scrotal oedema resolution in 37.5%of the patients treated.While almost half of the patients(53.3%)with associated penile oedema described persistent postoperative penile oedema,only two patients complained of persistent lymphorrhea.Conclusion:According to our clinical experience,preoperative and postoperative physical functional therapy is always recommended.For stages I and IIA,after the failure of the conservative treatment,lymph-venous shunts and lymph node transplantation surgery are proposed at the early time.When GL is already diagnosed at stages IIB and III,the debulking surgery,together with functional procedures,represents our first approach.展开更多
Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients...Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.展开更多
文摘Aim:Genital lymphoedema(GL)is a chronic and debilitating disease,which can severely affect the patient’s quality of life with significant socio-economic impact.Nowadays,no gold standard algorithm exists for GL from diagnosis to treatment.This study proposes our therapeutic flowchart based on the three senior consultants’experience in lymphatic surgery.Methods:A retrospective investigation was conducted on a prospectively maintained database(2018-2022).Inclusion criteria involved all patients who underwent surgical procedures for treating GL in three plastic surgery departments(Lausanne,Bari,and Genova).Outcomes were assessed in terms of oedema reduction,stage regression,and functional reported outcomes.Results:16 patients with GL were included:50%underwent debulking surgery,18.8%microsurgery,and 31.2%debulking+microsurgery.We recorded a significant regression of the GL stage:62.5%shifted from stage II/III to postoperative stage I.Similarly,we found an infection recurrency resolution in 50%,a scrotal oedema reduction in 62.5%,and a scrotal oedema resolution in 37.5%of the patients treated.While almost half of the patients(53.3%)with associated penile oedema described persistent postoperative penile oedema,only two patients complained of persistent lymphorrhea.Conclusion:According to our clinical experience,preoperative and postoperative physical functional therapy is always recommended.For stages I and IIA,after the failure of the conservative treatment,lymph-venous shunts and lymph node transplantation surgery are proposed at the early time.When GL is already diagnosed at stages IIB and III,the debulking surgery,together with functional procedures,represents our first approach.
文摘Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.
