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Lymphatic Pathways on Indocyanine Green Lymphography in Patients with Labia Minora Hypertrophy
Ye Yuan1, Fengyong Li1, Yu Zhou1
1From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Plastic and Reconstructive Surgery
|August 30, 2023
Summary
Indocyanine green (ICG) lymphography reveals distinct lymphatic pathways in the labia minora, suggesting lymphedema is uncommon in labia minora hypertrophy (LH). This mapping aids surgical planning for female genitalia procedures.
Area of Science:
- Gynecology
- Plastic Surgery
- Medical Imaging
Background:
- Labia minora hypertrophy (LH) presents an increasing aesthetic concern.
- The precise etiology and lymphatic anatomy of LH are not well understood.
- Investigating lymphatic drainage is crucial for understanding potential underlying pathologies.
Purpose of the Study:
- To utilize indocyanine green (ICG) lymphography to assess for lymphedema in patients with LH.
- To delineate the superficial lymphatic anatomy of the labia minora.
Main Methods:
- Preoperative ICG lymphography was performed on 35 patients with bilateral labia minora hypertrophy.
- Demographic, imaging, and measurement data were analyzed.
- Superficial lymphatic pathways were mapped and characterized.
Main Results:
- ICG lymphography showed predominantly linear lymphatic patterns (97.1%) with minimal dermal backflow (2.9%).
- Three primary superficial lymphatic pathways (superior, median, inferior) were identified, connecting the labia minora to the labia majora and clitoral hood.
- Three types of lymphatic mapping were classified based on the presence of these channels.
Conclusions:
- ICG lymphography effectively visualizes superficial lymph flow from the labia minora.
- Lymphedema does not appear to be a common cause of labia minora hypertrophy.
- Detailed knowledge of labia minora lymphatic anatomy is essential for guiding surgical interventions in the female external genitalia.
