Urology Case ReportsDoctors were left stunned when a man was brought to hospital with a scrotum so swollen it was bigger than a football.
The 43-year-old patient, from Panama, was rushed to hospital with a fever and two open wounds in his scrotum which were expelling a foul-smelling pus.
The man, who hadn’t been to the doctors for the past three decades despite his scrotal swelling gradually worsening during that time, was unable to move without a walker because his genitals had become so heavy.
Urology Case ReportsAs well as relying on a walker, the 43-year-old’s mother had to help him with most of his daily tasks, with his scrotum measuring 30.2cm x 24.4cm x 13.1cm (12″ x 10″ x 5″).
Doctors diagnosed the man with Fournier’s gangrene, a rare but life threatening disease which kills soft tissues – often quickly – including muscles, nerves, and blood vessels.
His condition was further complicated by massive lymphedema (swelling) of the scrotum and right leg, doctors reported in the medical journal Urology Case Reports, which weighed 7lbs and meant his genitals nearly touched the floor.
As per the report:
On examination, there was massive scrotal edema with displacement past the level of his knees. The scrotal skin was thickened and there were two open wounds with foul smelling, purulent fluid located at the bottom of the left hemi-scrotum. His right lower extremity had extensive edema and skin thickening of the upper leg.
Urology Case ReportsDoctors in the Central American country of Panama gave the man a CT scan of his abdomen and pelvis, which showed a massive hernia in his groin. He also had a large abscess under his skin, with gas measuring up to 12.8cm.
Fluid had collected in the left hemiscrotum and his scrotal wall had ‘extensive thickening,’ with his left kidney being severely swollen due to a build-up of urine. Not only that, but his flesh was effectively rotting.
Due to growing concern about the patient’s Fournier’s gangrene and his declining clinical condition, the man underwent emergency surgery to remove the infected scrotal skin and related tissue.
While operating, doctors discovered yet another large abscess which needed to be removed, although attempts to insert a catheter proved difficult because of a ‘buried penis’.
Urology Case ReportsSurgeons eventually accomplished the procedure after making an incision along the upper length of his foreskin to the head of his penis.
After five days of intravenous antibiotics, the decision was made to proceed with plastic surgery after it became obvious dressing changes were proving too painful.
The patient therefore underwent a scrotectomy (the complete or partial removal of the scrotum) before having a skin graft for the penis and primary closure of the perineum (the area between the anus and the scrotum) with advancement flap closures.
He was seen four weeks later and was healing well.
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A Broadcast Journalism Masters graduate who went on to achieve an NCTJ level 3 Diploma in Journalism, Lucy has done stints at ITV, BBC Inside Out and Key 103. While working as a journalist for UNILAD, Lucy has reported on breaking news stories while also writing features about mental health, cervical screening awareness, and Little Mix (who she is unapologetically obsessed with).