COMPLEX CLINICAL CASE IN THE NMRRC OF THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

Wen, or, in medical terms, atheroma, blockage of the sebaceous glands, at first glance, is a completely harmless skin disease. Often, if they do not interfere or are not noticeable, patients do not pay attention to them or try to get rid of them on their own.

However, our patient of the N. Lopatkin SRI of Urology and Interventional Radiology – branch of the Federal State Budgetary Institution of the “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation Maxim encountered such a rather rare urological disease as atheroma of the scrotum. According to the patient himself, wen appeared on the skin a long time ago, but constantly continued to increase not only in size, but also in quantity. Of course, our patient was seen by urologists at his place of residence, but no one dared to help him.

This is because Maxim had another serious chronic disease, which radically changed approaches to treatment, Glanzman’s thrombasthenia. This is platelet dysfunction, or poor blood clotting, which leads to spontaneous and post-traumatic bleeding. That is why doctors did not dare to use conventional methods for removing atheromas from Maxim’s scrotum and sent him for a consultation at the Scientific Research Institute of Urology.

Professor R.M. Safarov, the chief researcher of the department of oncourology and a specialist who not only has extensive experience in urological surgery, but also specializes in operations on patients with blood problems, agreed to help Maxim.

“We encountered a rather rare case: our patient had more than 50 atheromas on the skin. And these are only those that were obvious and large. All the tissue between them is affected by blockages of the sebaceous glands, smaller ones, so there was no point in removing each one separately, notes Ravshan Mukhitdinovich. We decided to perform a subtotal excision of the scrotum, remove all the affected skin, preserving as much as possible the clean part, and perform scrotal plastic surgery with local tissue.”

Considering the concomitant disease, surgery could cause large blood loss, so during the operation, specialists used all the necessary drugs to prevent such complications.

“We chose a step-by-step treatment strategy for coagulation and resection using a non-contact scalpel and multi-frequency radio waves. This helped to significantly reduce tissue trauma, allowing the surgical area to heal much faster without the risk of scarring and the possibility of wound infection.”

In the second stage, doctors performed plastic surgery to reconstruct the scrotum from preserved tissue. For a 24-year-old man, this is, of course, an extremely important factor, because now he can return to his normal full life.