Very little has been written concerning the surgical management of genital lymphedema or elephantiasis. The literature has contained a few isolated case reports with descriptions of surgical techniques used and the result of therapy.
De Savitsch in 19411 described a method whereby the diseased skin together with the gelatinous layer is removed from the penis. No skin graft was employed. Granulation tissue covers the denuded area, with eventual proliferation of epithelium from the border of healthy skin. McDonald and Huggins in 19503 recommended surgical bypass of the obstructed lymphatics. This was accomplished by anastomosis of the scrotum to the thigh, similar to the first stage of the Torek procedure. Finkle and co-workers in 19542 used split-thickness skin grafts to cover the surgically denuded penis. Morales, O'Connor, and Gordon also in 19544 described a similar procedure, using a dermatome split-thickness graft over the denuded area.