Genital Lymphedema Score: Genital Lymphedema Severity Scoring System Based on Subjective Symptoms

Genital lymphedema (GL) causes irritating symptoms such as urinary troubles due to genital edema and genital lymphorrhea, which deteriorate patients' quality of life. Indocyanine green genital lymphography has been reported to be useful for severity evaluation of GL but is not available in all medical settings. More convenient and simple severity evaluation methods are required in clinical practice.

Thirty-two female secondary lower extremity lymphedema patients with GL were evaluated using the genital lymphedema score (GLS) based on patients' symptoms related to GL (score from 0 to 9; higher is worse) and the genital dermal backflow (GDB) stage based on indocyanine green lymphography findings. The GLS was compared according to GDB stage.

The GLS ranged from 1 to 9 (mean, 3.0), and GDB stage ranged from I to IV (9 in GDB stage I, 13 in GDB stage II, 8 in GDB stage III, and 2 in GDB stage IV). There was a significant difference between GLS in GDB stage I, GDB stage II, GDB stage III, and GDB stage IV [1.2 (0.4), 2.4 (0.5), 4.8 (0.9), and 8.0 (1.4), respectively; P < 0.001).

The GLS was well associated with pathophysiological GL severity staging system and increased with progression of GDB stage. Because GLS is more convenient and simple than GDB stage, GLS is useful for primary evaluation of GL.