Filariasis is a tropical disease commonly found in India that affects the body’s lymphatic system. It is caused by an infection from the filarial parasite, Wuchereria bancrofti, transmitted to humans through mosquito bites. Unfortunately, this disease is often neglected by those who suffer from it.
About Kayakriti and Your Surgeon
A short walk-through of our Lucknow clinic, plus a brief introduction from Dr. Amit Agarwal.
Filariasis is a tropical disease commonly found in India that affects the body’s lymphatic system. It is caused by an infection from the filarial parasite, Wuchereria bancrofti, transmitted to humans through mosquito bites. Unfortunately, this disease is often neglected by those who suffer from it.
It is often neglected by the people suffering from it.
The lymphatics of the legs and genitalia get blocked after the infection leading to the accumulation of fluid and swelling in the legs and genitalia.
Symptoms of Filariasis
It causes Lymphoedema , and swelling of the leg and genitalia due to blockage of lymphatics of the lower limb and genitalia. It is usually acquired in childhood which manifests later in life and can lead to permanent disability.
What is Elephantiasis of Legs and Genitalia (Hathi Pav)?
When lymphatic filariasis is left untreated, it can progress to elephantiasis—a condition characterized by the enlargement and hardening of body parts. This advanced stage is particularly challenging and can lead to severe psychological embarrassment for affected individuals.
Impact of Elephantiasis in India
Elephantiasis of the legs and scrotum is a significant concern in India, especially for those who suffer from it. The unsightly appearance and associated social discrimination and ostracization pose grave challenges for affected individuals.
Men live through their whole lives with this condition without any treatment and have often faced social discrimination and boycotts.
Early Symptoms Of Filariasis In Leg Or Genitalia
Swelling of leg and/or scrotum not attributed to any other cause.
The feeling of fullness or heaviness.
Itching and Burning sensation.
Complications of Untreated Lymphatic Filariasis
Recurrent infections /oozing of fluid out from the skin of the affected part
No clothes fitting the part or legs
Thick skin, deformed part leading to elephantiasis.
Deformed penis and scrotum
Urinary problems, retention, and infections
Unable to have sex.
Diagnosis of Lymphatic Filariasis
Physical examination and history give a clue about the diagnosis.
A radioactive dye is injected into the lymphatics and then scanned by a probe to know and delineate the flow of lymph through the lymphatic vessels to diagnose the obstruction of lymphatics.
MRI of the part.
Early Treatment of Lymphoedema
Medicines specific for infection for 21 days.
Compression therapy.
Limb elevation.
Massage therapy and exercises.
Preventing infection.
Microsurgical Approaches
If the patient seeks treatment in the initial phases of the lymphoedema before the limb is deformed, then a microsurgical approach can be adopted.
1. Free vascularized lymph node transfer: Superficial lymph nodes are harvested from the neck region with an artery and vein and microsurgically anastomosed to a recipient artery and vein after tissue release in the ankle region.
Advantage of recruitment of healthy vascularized tissue
Challenging and technically demanding procedure
Post-op period with initial rigorous monitoring and maintenance of position by the patient.
Subjective improvement was reported by 100% of patients with 78% being able to discontinue compression therapy.
2. Lympho-venous bypass: We rarely get patients suitable for this procedure. In this procedure, the blocked lymphatics are connected to the veins.
Super-microsurgical technique to anastomose distal subdermal lymphatic vessels and adjacent venules <0.8mm.
Minimally invasive, minimal pain, discharged within 24 hours.
Challenging and technically demanding procedure.
Reduction/Excision Techniques
If the leg is severely deformed by elephantiasis or is in an advanced stage of lymphoedema, then debulking procedures will help in reducing the severity of the disease.
Modified Charles procedure = Excisional debulking of the deformed skin and tissues and covering the defect by skin graft. VAC therapy is given for 5 to 7 days after the surgery to ensure graft uptake.
Homan procedure staged longitudinal excision of skin and subcutaneous tissue medially and laterally in 2 separate stages with layered closure.
Recovery After Surgery For Filaria Of The Leg
a) Alternate day dressing with IV antibiotics and limb elevation for about 2 weeks with
b) Crepe bandage application and suture removal after about 2 weeks.
c) Gradually the patient is mobilized with pressure garment application and massage therapy.
d) Patients are educated about therapeutic exercises and skin care.
Treatment of Filariasis of Genitals
Elephantiasis of the genitals is a matter of great concern for all men who have it. It causes severe psychological embarrassment to men due to its unsightly appearance.
Men live through their whole lives with this condition without any treatment and have often faced social discrimination and boycotts.
They suffer a lot of issues because of this disease-
Deformed penis and scrotum.
Urinary problems, retention, and infections.
Unable to have sex.
They often seek medical help when the penis and scrotum is already deformed. Most of the patients are too shy and even embarrassed to discuss with the doctors.
Dr Amit Agarwal specializes in the treatment of elephantiasis of genitals and has helped hundreds of men to lead happy and productive lives. He has devised his own technique of reduction or debulking procedure for such deformed genitals. Men are able to return to their normal lives with minimum complications after this surgery.
Patients are kept in the hospital for a minimum of 5 days and regular dressings are done on alternate days. Sutures are removed in 14 days.
See the difference
Before & After — Filariasis
Drag the handle to compare. All photos are real patients shared with consent.
Before
After
Before
After
Images shown are intended to provide general treatment insight only.
Every patient is unique, and outcomes may vary depending on individual
condition and treatment plan.
Common questions
Frequently asked questions
What is filariasis, and how is it transmitted?
Filariasis is a tropical disease caused by the filarial parasite Wuchereria bancrofti, which is transmitted to humans through mosquito bites.
What are the common symptoms of filariasis?
Typical symptoms include swelling in the legs and genitalia, especially in the later stages. This can lead to a condition known as elephantiasis.
Is elephantiasis a severe problem in India?
Yes, elephantiasis of the legs and genitalia is a significant concern in India, causing physical and psychological challenges for those affected.
What are the early signs of filariasis in the legs or genitalia?
Early signs may include leg or scrotal swelling, feelings of fullness or heaviness, itching, and burning sensations.
What complications can arise from untreated lymphatic filariasis?
Neglected cases can lead to recurrent infections, difficulty finding well-fitting clothes, thickened and deformed skin (elephantiasis), urinary problems, and sexual dysfunction.
How is lymphatic filariasis diagnosed?
Diagnosis involves a physical examination and may include procedures like lymphoscintigraphy, MRI, and other imaging methods to assess lymphatic blockages.
Can lymphoedema of the leg be treated without surgery?
Yes, early-stage lymphoedema can be managed with medicines, compression therapy, limb elevation, massage therapy, exercises, and preventive measures.
What are the surgical options for severe filariasis of the legs?
In advanced cases, microsurgical approaches, such as free vascularized lymph node transfer and lymph-venous bypass, may be considered. Reduction/excision techniques like the Modified Charles procedure and the Homan procedure are also options.
What is the recovery process after surgical treatment for filariasis of the legs?
Recovery typically involves alternating day dressings, IV antibiotics, limb elevation, pressure garment application, therapeutic exercises, and skin care education.
How is filariasis of the genitals treated at Kayakriti?
Filariasis of the genitals is treated with specialized reduction or debulking procedures at Kayakriti, allowing patients to return to a normal life with minimal complications. Dr. Amit Agarwal’s expertise in this area ensures effective and compassionate care.
Real stories
What our patients say about Kayakriti
★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
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★★★★★
"My brother is diabetic and hurt his leg; the wound was not healing for a long time. Dr Amit debrided all the infected part and covered it with a flap. The wound is now healed — we are lucky we got the correct treatment on time."
