Lymphedema is defined as the increase in intercellular fluid in relation with a failure in the lymphatic system. When the lymphatic system does not operate correctly with any reason whatsoever or if the lymph canals are unable to drain the fluid properly, fluid can accumulate within the tissues. When the amount of fluid accumulating is greater than the capacity of fluid transport, lymphedema forms. Lymphedema can be congenital or can occur in any stage of life. Preoperative lymphedema can develop right after the operation, or more commonly, it develops slowly and shows itself 1 or 2 years following the operation.
Signs of lymphedema that can occur in the face, neck, arms, legs, abdomen and lungs are as follows:
- Pain in axillary and inguinal areas and locations where there is hardness
- Sensation of tightness and hardness in the skin
- Somnolence
- Visible deformation
- Discomfort
- Infections with repeating attacks
- Lymphedema can cause thickening of the skin, hardness in arms or legs, and swelling (elephantiasis) in advanced cases or cases left untreated
- Swelling in certain areas
- Limitation of movement in swollen places.
Primary (congenital) lymphedema; Occurs as a result of the insufficient development of lymph canals in the intrauterine life.
Secondary lymphedema: Secondary lymphedema most commonly appear following surgical procedures performed in relation with cancer and radiotherapy. During the cancer surgery, relevant lymph nodules are also removed together with the removal of the cancer. This operation will in time deteriorate the lymph circulation and can cause lymphedema.
Lymphedema resulting from chronic venous insufficiency; Inability of veins in transporting blood to the heart is defined as “venous insufficiency”. Venous insufficiency is mostly seen in legs in the calf area.
Lymphedema resulting from lipedema; Lipedema is a women’s disorder with unknown cause. This disease starts with the onset of menstruation and sometimes during the pregnancy. Symmetrical fat deposits are seen in both legs in lipedema. Lipedema can also be seen in arms. The amount of water and protein, transportation of which is the duty of lymph canals, increases with the increasing fat ratio in the body. As a consequence, the overly working lymph system fails and becomes unable to carry out its duties.
The definitive diagnosis of lymphedema causing swelling in arms and legs in general can be made with ultrasonic imaging. Lymphedema patients can have signs including heaviness in the arm, pain and inability to move the arm comfortably. If definitive diagnosis is not possible with ultrasound, the doctor can make use of other imaging methods.
Lymphedema treatment consists of 4 different methods:
- Manual lymph drainage
- Compression (bandaging and stockings)
- Skincare
- Exercise