TWO MAJOR types of scrotal elephantiasis, arabum (tropicum) and nostros (nostra) are recognized.1 Elephantiasis arabum develops secondary to filarial blockage of lymphatics; the nostrum type is sporadic and due to nonfilarial obstruction of lymph drainage from the inguinofemoral areas. Of the latter group, lymphopathia venereum is probably the most frequent venereal cause in this country. Granuloma inguinale, which may not actually be a true "venereal" disease,2 is less commonly an etiological agent.3
Medical treatment is ineffective for long-standing elephantiasis of the genitalia from whatever cause. In both lymphopathia venereum and granuloma inguinale, the maximum value of antibiotic therapy is attained if treatment can be administered early.
There has been little published in America on the surgical treatment of scrotal elephantiasis. Hinman1 depicted a radical surgical removal of the scrotum by Kretchmar and recommended this procedure, to be followed by plastic formation of new penile and scrotal