Surgical treatment of penoscrotal lymphedema with Re-implantation of the testicles in the thigh

Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow from the penis and scrotum with subsequent enlargement. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation and sexual intercourse. The treatment of lymphedema of the penis and scrotum is by removing affected tissues and correcting the penoscrotal region. This presents a case of huge penoscrotal lymphedema; severe penile fibrosis, recurrent urinary tract infections and a non healthy perineal skin. After complete resection of the affected tissues, it was difficult to reconstruct the scrotum, so the operation was completed by re-implanting the testicles. It was conclude that the modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better cosmetic results in the affected area with remarkable improvement in quality of life

Congenital umbilical appendix

We report a case of a 3 years old female with umbilical appendix presenting with a fistula. Initial examination, which was done by a midwife, missed a congenital appendix protruding through the umbilicus. Ligation of this cord resulted in fistula formation. The patient was successfully managed by doing an appendectomy. Congenital umbilical anomalies are rare, only handful of cases have been reported so far. Most umbilical neonatal anomalies described in literature are derived from the vitelline duct. In this article we describe the clinical presentation and management of an umbilicus appendix presenting with a fistula following umbilical cord ligation. We also review the embryological origin, and aetiological facors