Introduction. Lymphedema (elephantiasis) of the scrotum is a rare disease. Pathology can be parasitic on the background of filariasis, congenital and secondary, with sexually transmitted infections (STIs) as well as after an injury. The early diagnosis of lymphedema presents great difficulties and in most cases tends to progression and recurrence. As of today, there are no sound recommendations for the treatment of patients with this pathology.

Materials and methods. In April 2018 a 21-year-old patient applied to the Department of Oncourology of the RSSPMCOR with complains of an increase in the scrotum to a gigantic size and the inability to maintain hygiene and difficulty in moving. The patient had signs of low mental status during communication. After examination and exclusion of parasitic etiology in this case the patient underwent surgical management. Intervention included phased removal of hypertrophic scrotum tissue followed by reconstructive plastic surgery using patient’s own soft tissues.

Results. The stages of interference to remove hypertrophic tissues and plastic reconstruction of the pudenda took about three and a half hours. On the background of postoperative symptomatic rehabilitation therapy, postoperative wounds healed in time by primary intention. The recovery period included consultations of a psychotherapist, which significantly improved the patient's psychosomatic state by the time of discharge.

Conclusions. Surgical removal of hypertrophic scrotal skin with various options of reconstructive plastic surgery of the pudenda cover as well as a multidimensional approach during the postoperative recovery period is one of the most effective treatment methods that significantly improves the quality of life of patients.

Conflict of interest. The authors declare no conflict of interest.