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While filariasis is well managed pharmacologically, surgical strategies for genital elephantiasis vary and can be difficult to interpret. This review analyzes etiology, classification, severity grading, and commonly used surgical and reconstructive options from the early twentieth century onward.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/genital-elephantiasis-surgical-treatment-and-reconstruction-review-article/436181/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/genital-elephantiasis-surgical-treatment-and-reconstruction-review-article/436181.png","ImageObject",300,407,{"name":92,"@type":93},"Miles","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is genital elephantiasis and what challenges does it cause?","Question",{"text":112,"@type":113},"Genital elephantiasis is severe groin lymphedema with progressive genital enlargement and distortion. It causes significant physical morbidity and also major psychological and social impacts.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How is genital elephantiasis related to lymphedema etiologies?",{"text":117,"@type":113},"The article explains that any persistent lymphedema—whether congenital or related to conditions such as cancer—can lead to soft tissue hypertrophy and eventual elephantiasis.",{"name":119,"@type":110,"acceptedAnswer":120},"How does the review classify lymphedema?",{"text":121,"@type":113},"Lymphedema is classified as primary or secondary. Primary lymphedema is subdivided by age of onset into congenital, praecox, and tarda forms, while secondary lymphedema results from lymphatic system insults causing sclerosis and obstruction.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436181,1790895269,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},13056703019404,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","J Chin MedAssoc  \nReview ARticle  \nGenital elephantiasis: Surgical treatment and reconstruction  \nJeremy Mingfa Suna,b, Takumi Yamamotob,*  \naDepartment of Surgery, Plastic Reconstructive and Aesthetic Surgery Service, Changi General Hospital, Singapore; bDepartment of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan  \nAbstract  \nGenital elephantiasis is a severe form of lymphedema of the groin. It is characterized by progressive enlargement and distortion of the genitals, presenting significant physical, psychological, and social challenges to the affected individuals. Although pharmacological treatment of filariasis is well-established in the medical field, the surgical management of genital elephantiasis can be varied and confusing. This review article provides an in-depth analysis of the etiology, classification, severity grading, and various effective surgical treatment and reconstructive modalities commonly employed by surgeons since the early twentieth century. We also discuss how a combination approach of ablation, soft tissue coverage, and lymphatic reconstruction is viable for treating genital elephantiasis. By examining the literature, we hope to provide insights into how surgery plays a role in the holistic management of genital elephantiasis.  \nKeywords: Charles procedure; Genital elephantiasis; Lymph vessel transfer; Lymphatic reconstruction; Lymphedemadebulking  \n1. INTRODUCTION  \nGenital elephantiasis has been classically thought of as a chronic, severe swelling, and hypertrophy of the genital soft tissue due to lymphatic filariasis. We now know that lymphedema of any etiology, congenital, or cancer-related, if left unchecked, will result in soft tissue hypertrophy, dermal hyperkeratinization, and eventual elephantiasis.  \nA fraction of patients with lower extremity lymphedema will suffer from genital lymphedema. However, the true incidence of genital lymphedema and elephantiasis is poorly understood. Recently, Clinckaert et al1 performed a systematic review to determine the prevalence of lower limb and genital lymphedema after prostate cancer treatment. From the 18 articles reviewed, the group found a prevalence of lymphedema in the lower limbs and genital regions ranging from 0% to 14% and 0% to 1% after surgery and 0% to 9% and 0% to 8% after pelvic radiation, respectively. There was a much higher prevalence inpatients that underwent pelvic lymph node dissection followed by pelvic radiotherapy (18%-29% and 2%-22%) . For congenital lymphedema, a study of 138 children from Children’s Hospital Boston found that males were seven times more likely to have genital lymphedema than females.2  \n* Address correspondence. Dr. Takumi Yamamoto, Department of Plastic and Reconstructive Surgery, Center Hospital of National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail address: [tyamamoto-tky@umin.ac.jp](tyamamoto-tky@umin.ac.jp) (T. Yamamoto).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2024) 87: 142-147.  \nReceived July 27, 2023; accepted August 29, 2023. doi: 10. 1097/JCMA.0000000000001021  \nCopyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nGenital lymphedema and elephantiasis can impart significant physical morbidity to our patients. Patients may experience multiple episodes of cellulitis, difficulty fitting clothes, swelling discomfort, and malignant transformation from repeated ulcerations. This entity can negatively impact their psychosocial well-being as well. Patients often report lowered self-esteem and poor sexual function. Features of genital elephantias","cbCailtnFOpWnQiW","https://ap.wps.com/l/cbCailtnFOpWnQiW","pdf",467539,"English","# Introduction\n# Classification and Etiology","[{\"question\":\"What is genital elephantiasis and what challenges does it cause?\",\"answer\":\"Genital elephantiasis is severe groin lymphedema with progressive genital enlargement and distortion. It causes significant physical morbidity and also major psychological and social impacts.\"},{\"question\":\"How is genital elephantiasis related to lymphedema etiologies?\",\"answer\":\"The article explains that any persistent lymphedema—whether congenital or related to conditions such as cancer—can lead to soft tissue hypertrophy and eventual elephantiasis.\"},{\"question\":\"How does the review classify lymphedema?\",\"answer\":\"Lymphedema is classified as primary or secondary. Primary lymphedema is subdivided by age of onset into congenital, praecox, and tarda forms, while secondary lymphedema results from lymphatic system insults causing sclerosis and obstruction.\"}]","Genital elephantiasis - Surgical treatment and reconstruction - review article | PDF",1790677072,15]