A novel 'Batman' scrotectomy technique for the management of scrotal lymphoedema following treatment for penile cancer.

To describe a novel 'Batman' scrotectomy technique and present our single centre experience in the management of secondary scrotal lymphoedema in penile cancer patients.

A retrospective review of the medical records of penile cancer patients with extensive and bothersome penoscrotal lymphoedema failing conservative therapy between 2013 and 2018. We analysed patients' demographics, pre-operative disease stage, post-operative outcomes and complications.

Seven patients with a history of penile cancer and problematic scrotal lymphoedema were managed using a novel 'Batman' scrotectomy technique. The mean age was 56.4 (range, 28-71) years. The mean inpatient stay was 4.1 (range, 2-7) days. Two patients (28.6%) were found to have incidental metastatic squamous cell carcinoma (SCC) in the scrotal skin on histological analysis. One patient developed superficial wound dehiscence (Clavien-Dindo grade II) and two patients had mild post-operative residual penile lymphoedema. Following a mean follow-up period of 19 months, 2 patients died due to metastatic penile cancer. One patient developed skin metastases in his thigh and perineum. All of the patients reported a good cosmetic and functional outcome on post-operative review.

Genital lymphoedema is an uncommon side-effect of penile cancer treatment. In severe cases where patients fail conservative treatments, surgical intervention using this technique is effective and feasible.

Translational andrology and urology. 2019 Oct [Epub]

Hussain M Alnajjar, Fabio Castiglione, Kamran Ahmed, Aiman Haider, Raj Nigam, Asif Muneer

Department of Urology, University College London Hospitals NHS Trust, London, UK., Department of Pathology, University College London Hospitals NHS Trust, London, UK.