title: Successful complex decongestive physiotherapy for lymphedema and lymphocutaneous reflux of the female external genitalia after radiation therapy.
abstract: Development of secondary lower extremity lymphedema after cervical cancer is common. However, severe lymphedema of the female genitalia and vesicular cutaneous lymphatic reflux without lower limb lymphedema after treatment of cervical cancer is rare. We report successful complex decongestive physiotherapy (CDP) in a 53-year-old female who developed recurrent folliculitis, lymphocutaneous reflux, warty change of the right labium majora, and lymphedema involving the external genitalia after receiving hysterectomy, pelvic lymph node dissection, and radiation. CDP included skin care, manual lymphatic drainage, exercise, and use of a hip spica bandage and panty girdle garment. Oral antibiotics were prescribed to control the skin infection. Lymphatic discharge and folliculitis were markedly improved after a 3-week course of treatment. Traditional conservative treatment with pneumatic compression and massage is ineffective and not suitable in controlling lymphedema of the external genitalia. Use of CDP may help to relieve the symptoms and recurrent infection in patients with this condition.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Su Fen
authors.initials: SF
authors.lastname: Liao
authors.forename: Mu Shen
authors.initials: MS
authors.lastname: Huang
authors.forename: Ya Hui
authors.initials: YH
authors.lastname: Chou
authors.forename: Ta Sen
authors.initials: TS
authors.lastname: Wei
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005836:Genitalia, Female / Q000473:pathology*; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008209:Lymphedema / Q000209:etiology / Q000534:rehabilitation*; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy* / Q000601:surgery