Genital lymphoedema

Genital lymphoedema, just like any lymphoedema of the body, occurs when there is an interruption of the lymphatic drainage of that area. We refer here to lymphoedema, secondary to urogenital cancers and/or its treatment e.g. radiotherapy, surgery and lymph node dissection.

The nodes that drain the urogenital areas are found in the lumbar area, the pelvis and the groin. Genital swelling is very commonly accompanied by one or both legs being swollen. When treating a patient for urogenital oedema, the affected leg/s must be considered.

The first sign of genital oedema is a soft tissue swelling, which can be painless. The area might be slightly red as the swelling will be accompanied by a low grade inflammation. The area could also be prone to infection due to the high levels of protein in the tissues as well as the fact that the now, compromised lymphatic drainage system, which normally acts as an alarm system for infection, is not working efficiently.

In men the pubic area and the area just above it together with the penis and scrotum could be involved. Because the scrotum does not have any bony or muscular structures to facilitate lymph drainage and due to the force of gravity, swelling of the penis and scrotum can be difficult to treat. Scrotal swelling can make walking uncomfortable. The supra pubic swelling could cause the penis to retract into the scrotum, leading to difficulty in urinating. Sexual activity and personal hygiene could also become a challenge. Thus the emotional effects can be devastating, resultant in poor self-esteem and embarrassment.

In women, the swelling might occur in the pelvis and in the outer lips of the vagina. After internal radiation therapy the vagina, up to the cervical area could become swollen and the tissue can break down. Because of this strict hygiene habits must be practiced. As with men, the problems with urination, sexual behavior and in female’s defecation, could result in emotional trauma.

For all genital oedema the major complication is cellulitis. Report any flu like symptoms to your doctor immediately.

Management of genital oedema includes:
  • Manual lymph drainage massage, which the patient could learn to do independently, daily.
  • Meticulous hygiene and skin care. Wash the area gently and dry well especially in the folds.
  • A good specialised exercise program.
  • Specialised genital bandaging for men. 
  • Compression garments e.g. a scrotal sling for men, specially made compression foam pads and cycling shorts. Wear leg compression stockings if necessary.

Written by Sue Serebro.