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What Is Scrotal Lymphedema?

Scrotal lymphedema occurs when you have a blockage in the lymphatic vessels in your scrotum. Your scrotum is the sac beneath your penis that holds your testicles, which make sperm. Scrotal lymphedema causes your scrotum to thicken and grow to the size of a grapefruit or hang below your knees. When the scrotum swells this significantly, it’s called massive scrotal lymphedema or giant scrotal lymphedema.  

Lymphatic vessels help drain lymph, the colorless fluid that brings nutrients to your cells. Lymph also helps protect your body from bacteria and viruses. A block in your lymphatic vessels causes your lymph to build up. This blockage and lymph build-up is called lymphedema. Lymphedema can affect many parts of your body. It causes painful swelling and can lead to a long-lasting tissue infection. 

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Scrotal Lymphedema Symptoms

The main symptom of scrotal lymphedema is swelling. You may also have other symptoms that affect your scrotal area: 

  • Chronically infected skin

  • Doughy, fluid-filled skin

  • Skin thickening 

In severe cases, your penis can become buried in the tissue of the scrotum. This is called a buried penis. 

Scrotal lymphedema can cause serious pain and distress. In fact, patients who have the condition often become housebound. 

Scrotal Lymphedema Causes

Often, scrotal lymphedema happens after cancer surgery or radiation therapy for cancer. But you can also get scrotal lymphedema for no known reason. This is called idiopathic scrotal lymphedema.

Scrotal Lymphedema Treatment

Surgery is often the best treatment to restore your quality of life. During the procedure, your surgeon will remove all the affected tissue. Then, they will reconstruct your scrotum. Most people have enough healthy tissue around the enlarged area to recreate a typical-looking scrotum. 

Sometimes patients with a buried penis also have skin infections and scarring on their penis. In these cases, your surgeon may remove the skin of your penis. Then they will replace it with a skin graft. They usually will take a small portion of skin from your thigh to replace the damaged skin on your penis. 

Scrotal Lymphedema Management 

Experts don’t know exactly why, but scrotal lymphedema often occurs in patients with large bellies. In these cases, a roll of fat from the abdomen may hang over the penis. This can make it more likely for the penis to get buried again after surgery. 

In these cases, your surgeon will remove excess fat during the same surgery to manage your lymphedema. This procedure is called an abdominoplasty or a tummy tuck.  

Scrotal Lymphedema Recovery After Surgery

The length of your hospital stay depends on the extent of your surgery: 

  • Sometimes, you may return home the same day.

  • You may stay overnight or a few days if you need a skin graft. 

You will need to avoid strenuous activity until you’ve fully recovered. We typically recommend not lifting more than 15 pounds for a month after surgery. 

You will need close follow-up to ensure you’re healing well. You may need to see your care team every 1–2 weeks. We can discuss how to make follow-up care convenient for you if you live outside the area. You may be able to see a urologist closer to home for your follow-up care and avoid repeat travel to our team.

Why Choose University of Utah Health?

Many conditions we treat, such as scrotal lymphedema, are rare. Patients come from all over the country to receive care with our team. For scrotal lymphedema, we make every effort to arrange your appointments and surgery within several days of your initial visit. 

Our reconstructive urologists will often see you via a virtual visit before your first appointment to help create an efficient care plan. We can also arrange for follow-up with a local urologist so you can continue to receive care close to home after surgery.

Make an Appointment

Call 801-213-2700 to make an appointment with our urology team. We don’t require a referral, but some insurance companies do. Our team can help you determine whether you need a referral before you schedule an appointment.

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