Lymphatic Embolization for Primary Genital Lymphorrhea and Chylous Reflux-Related Lower Limb Lymphedema.

Purpose: To evaluate the safety and efficacy of lymphatic embolization for primary genital lymphorrhea.

Materials And Methods: A retrospective analysis was conducted on patients who underwent lymphatic embolization for primary genital lymphorrhea and/or lower limb lymphedema between May 2016 and January 2022 at three specialized lymphatic centers. Following radiological evaluation of genital lymphorrhea, affected lymphatic vessels were selectively embolized to occlude abnormal lymphatic flow using a mixture of N-butyl cyanoacrylate glue and ethiodized oil. Clinical success was defined as the cessation of genital lymphorrhea or improvement of lymphedema at one-month follow-up visit.

Results: Among 11 patients (median age 27, age range 14-60, 10 men) included in this study, 5 patients had genital lymphorrhea, one had lower limb lymphedema, and the other 5 had both. Total 15 embolization procedures were performed with a technical success rate of 100%. Clinical success was achieved in 90% of genital lymphorrhea (9/10) and 50% of leg lymphedema (3/6). Three patients underwent additional embolization for recurrent genital lymphorrhea at 9 months after the embolization (n=1), and for further improvement of leg lymphedema per patients' request (n=2). A procedure-related adverse event with aggravation of pre-existing condition was reported in one patient.

Conclusion: Lymphatic embolization was effective in the management of primary genital lymphorrhea and associated primary lymphedema in lower limbs.