Clinical case:

A 52-year-old man was diagnosed with late giant primary penoscrotal lymphedema and treated with lymphangiectomy plus genital reconstruction. At the follow-up one year later, there was no disease recurrence and the preservation of sexual function was achieved.

Relevance:

The incidence of giant penoscrotal lymphedema is very low but its impact on morbidity is high. It is triggered by the accumulation of protein-rich fluid in subcutaneous cell tissue that produces deformity, loss of sexual function, and recurrent infections.

Clinical implications:

This clinical entity conditions a decline in patient quality of life by causing discomfort in walking, and especially, sexual function deterioration.

Discussion and conclusion:

Surgical treatment is currently the best therapeutic option, given that it prevents disease progression and deformity and preserves function. The best technique is lymphangiectomy plus genital reconstruction, which is described in the present case with favorable progression.