Pelvic lymphadenectomy can cause lymphedema in which areas?

• A. In only one leg
• B. In both legs
• C. In both legs and genitals
• D. All of the above

Answer: (D)

Lymphatic drainage from the lower body is disrupted when pelvic lymph nodes are removed. Lymph from a leg travels upward through the inguinal and femoral nodes into the pelvic lymphatics, and the external genitalia drain into the pelvic lymphatic system as well. If these pathways are interrupted, fluid can accumulate in the tissues served by them. Depending on how extensive the dissection is and which sides are affected, swelling can occur in one leg, both legs, and/or the genitals. Because pelvic lymphadenectomy can impact all these drainage routes, lymphedema can appear in any of these areas, making all of the above possible.