Although for many years it has been considered a predominantly female condition, lymphoedema also affects many men and frequently goes unnoticed or is diagnosed late. In this post, Dr. Jaume Masià, an internationally recognised specialist in the treatment of lymphoedema, focuses on a reality that receives little attention: how this condition affects men’s quality of life, its most common causes and the treatment options currently available to improve well-being and restore function.
The relationship between prostate cancer and lymphoedema
There is a direct connection between prostate cancer and lymphoedema, as a considerable percentage of patients who undergo surgery for this condition develop lymphoedema, generally in the genital area and, in some cases, also in the lower limbs.
Onset of lymphoedema: immediate or delayed?
Lymphoedema associated with prostate cancer does not always develop immediately. Its onset depends on the type of surgical impact on the patient’s lymphatic system:
- In some cases, following more aggressive surgery, lymphoedema may develop almost immediately.
- In others, if the surgery has been less invasive but is complemented by radiotherapy, it may develop months or even years later. In all cases, this depends on the impact of the procedure on the lymphatic system.
What is pelvic lymphadenectomy and how does it affect lymphoedema?
Pelvic lymphadenectomy involves removing lymph nodes located in the iliac system within the pelvis. This system functions like a motorway, collecting lymph from the lower limbs and genital area and transporting it towards the central part of the body. When these lymph nodes are removed, the natural flow of lymph is disrupted, increasing the risk of developing lymphoedema.
What is the lymphatic system?
The lymphatic system is a transport system involved in the body’s defence and cleansing processes. It runs parallel to the venous system and helps eliminate waste and harmful particles. It functions independently of the heart and contains lymphatic stations that act as filters, carrying out an initial selection of defence elements and waste products before the lymph continues its journey through the body.
Early symptoms of lymphoedema in men
Men often first notice symptoms such as a sensation of swelling or heaviness in the genital area or upper thigh. Over time, the scrotum may increase in volume, potentially becoming severe enough to make sitting or getting dressed difficult. This increase in size is one of the most characteristic and concerning signs of lymphoedema in men.
Diagnosis of lymphoedema in men
The initial clinical diagnosis is straightforward in most cases. However, to determine the most appropriate treatment, specialised imaging tests are required, such as lymphoscintigraphy, direct indocyanine green lymphography and MR lymphangiography. These tests make it possible to assess the extent of lymphatic system involvement and plan the most effective intervention.
Treatment options and microsurgery
Treatment for lymphoedema in men may include microsurgery to restore lymphatic flow. In advanced cases, when the lymphatic system has undergone degeneration, surgical resection or selective lymphatic liposuction may be necessary to remove excess accumulated fat. The choice of procedure depends on the stage and location of the lymphoedema.
Final message from Dr. Jaume Masià
Lymphoedema in men remains relatively unknown, even among healthcare professionals such as urologists and oncologists. The key recommendation is to seek treatment as early as possible, as the earlier the intervention, the better the response and recovery. Awareness and early detection are essential for improving patients’ quality of life.
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