PRIMARY LYMPHEDEMA OF THE GENITALIA IN CHILDREN AND ADOLESCENTS
Identifieur interne : 00B217 ( Main/Exploration ); précédent : 00B216; suivant : 00B218PRIMARY LYMPHEDEMA OF THE GENITALIA IN CHILDREN AND ADOLESCENTS
Auteurs : Jonathan H. Ross [États-Unis] ; Robert Kay [États-Unis] ; Randall J. Yetman [États-Unis] ; Kenneth Angermeier [États-Unis]Source :
- The Journal of Urology [ 0022-5347 ] ; 1998.
Descripteurs français
- KwdFr :
- Pascal (Inist)
- Wicri :
- topic : Enfant.
English descriptors
- KwdEn :
- MESH :
- congenital : Genital Diseases, Male, Lymphedema.
- surgery : Genital Diseases, Male, Lymphedema.
- Adolescent, Humans, Infant, Infant, Newborn, Male.
Abstract
Purpose Congenital lymphedema is a rare disorder that may result in disfiguring edema of the male genitalia. We reviewed our experience with 5 cases to advance our understanding of this challenging problem.Materials and Methods Four boys with significant lymphedema underwent excision of the involved subcutaneous genital tissue and coverage with local skin flaps. Two boys in whom this approach failed later underwent complete excision of the involved subcutaneous tissue and skin, and coverage with split thickness skin grafts. The boy with minimal edema was observed.Results Two of the 4 boys who underwent subcutaneous genital tissue resection and coverage with local skin flaps are markedly improved, although 1 requires further revision. In the other 2 boys treatment failed, necessitating repeat genital tissue excision and grafting. While there have been no recurrences in the grafted areas, each patient has required additional operations to manage recurrent edema in adjacent tissues of the perineum and inguinal region, and in 1 significant contraction of the grafted skin developed. Mild genital lymphedema in the remaining patient has remained stable during 10 years of followup.Conclusions Congenital lymphedema of the genitalia is a challenging problem. Recurrences requiring multiple operations are common. We recommend expectant management of mild cases. In more severe cases excision without grafting should be attempted. While skin grafting may be the most definitive solution, it does not prevent recurrence in adjacent regions, and it carries the risk of skin contraction. Skin grafts should only be used when other techniques have failed.
Url:
DOI: 10.1016/S0022-5347(01)62598-9
Affiliations:
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Ross</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>From the Sections of Pediatric and Reconstructive Urology, and Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Kay, Robert" sort="Kay, Robert" uniqKey="Kay R" first="Robert" last="Kay">Robert Kay</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>From the Sections of Pediatric and Reconstructive Urology, and Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Yetman, Randall J" sort="Yetman, Randall J" uniqKey="Yetman R" first="Randall J." last="Yetman">Randall J. Yetman</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>From the Sections of Pediatric and Reconstructive Urology, and Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Angermeier, Kenneth" sort="Angermeier, Kenneth" uniqKey="Angermeier K" first="Kenneth" last="Angermeier">Kenneth Angermeier</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>From the Sections of Pediatric and Reconstructive Urology, and Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland</wicri:cityArea></affiliation></author></analytic><monogr></monogr><series><title level="j">The Journal of Urology</title><title level="j" type="abbrev">JURO</title><idno type="ISSN">0022-5347</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1998">1998</date><biblScope unit="volume">160</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="1485">1485</biblScope><biblScope unit="page" to="1489">1489</biblScope></imprint><idno type="ISSN">0022-5347</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-5347</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Case study</term><term>Child</term><term>Genital Diseases, Male (congenital)</term><term>Genital Diseases, Male (surgery)</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Lymphedema</term><term>Lymphedema (congenital)</term><term>Lymphedema (surgery)</term><term>Male</term><term>Penis</term><term>Plasty</term><term>Primitive</term><term>Scrotum</term><term>Skin</term><term>Subcutaneous tissue</term><term>Surgical resection</term><term>Treatment</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Humains</term><term>Lymphoedème ()</term><term>Maladies de l'appareil génital mâle ()</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term></keywords><keywords scheme="MESH" qualifier="congenital" xml:lang="en"><term>Genital Diseases, Male</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Genital Diseases, Male</term><term>Lymphedema</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adolescent</term><term>Enfant</term><term>Etude cas</term><term>Humains</term><term>Lymphoedème</term><term>Maladies de l'appareil génital mâle</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Peau</term><term>Plastie</term><term>Primitif</term><term>Pénis</term><term>Résection chirurgicale</term><term>Scrotum</term><term>Tissu souscutané</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Enfant</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose Congenital lymphedema is a rare disorder that may result in disfiguring edema of the male genitalia. We reviewed our experience with 5 cases to advance our understanding of this challenging problem.Materials and Methods Four boys with significant lymphedema underwent excision of the involved subcutaneous genital tissue and coverage with local skin flaps. Two boys in whom this approach failed later underwent complete excision of the involved subcutaneous tissue and skin, and coverage with split thickness skin grafts. The boy with minimal edema was observed.Results Two of the 4 boys who underwent subcutaneous genital tissue resection and coverage with local skin flaps are markedly improved, although 1 requires further revision. In the other 2 boys treatment failed, necessitating repeat genital tissue excision and grafting. While there have been no recurrences in the grafted areas, each patient has required additional operations to manage recurrent edema in adjacent tissues of the perineum and inguinal region, and in 1 significant contraction of the grafted skin developed. Mild genital lymphedema in the remaining patient has remained stable during 10 years of followup.Conclusions Congenital lymphedema of the genitalia is a challenging problem. Recurrences requiring multiple operations are common. We recommend expectant management of mild cases. In more severe cases excision without grafting should be attempted. While skin grafting may be the most definitive solution, it does not prevent recurrence in adjacent regions, and it carries the risk of skin contraction. Skin grafts should only be used when other techniques have failed.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Ohio</li></region></list><tree><country name="États-Unis"><region name="Ohio"><name sortKey="Ross, Jonathan H" sort="Ross, Jonathan H" uniqKey="Ross J" first="Jonathan H." last="Ross">Jonathan H. Ross</name></region><name sortKey="Angermeier, Kenneth" sort="Angermeier, Kenneth" uniqKey="Angermeier K" first="Kenneth" last="Angermeier">Kenneth Angermeier</name><name sortKey="Kay, Robert" sort="Kay, Robert" uniqKey="Kay R" first="Robert" last="Kay">Robert Kay</name><name sortKey="Yetman, Randall J" sort="Yetman, Randall J" uniqKey="Yetman R" first="Randall J." last="Yetman">Randall J. Yetman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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