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

To evaluate the safety and effectiveness of lymphatic embolization for primary genital lymphorrhea.

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 3 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 1-month follow-up visit.

Among 11 patients (median age, 27 years; age range, 14-60 years; 10 men) included in this study, 5 had genital lymphorrhea, 1 had lower limb lymphedema, and the other 5 had both. A total of 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 1 patient.

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