Background & Aims

Lower extremity lymphedema is a chronic condition that occurs
mostly due to gynecologic malignancies and frequently affects the female
population. It is a chronic disease that often requires lifelong treatment and
psychosocial support that impairs quality of life in patients. The etiology of pain
in patients with lower extremity lymphedema can be categorized under three
headings: vascular, neurologic and musculoskeletal causes. The aim of this
study was to determine the frequency and etiology of pain in patients with
lower extremity lymphedema and to evaluate the effect of pain on quality of
life.

Methods

The study included 50 patients with lower extremity
lymphedema.Demographic and clinical information of the patients participating
in the study were recorded. The differential diagnosis of lower extremity pain is
divided into three categories as vascular, neurologic and musculoskeletal
causes through doppler ultrasound, X-ray, MRI and ultrasound. Health related
quality of life was measured with in patients with The Lymphedema Life Impact
Scale. The pain was evaluated with VAS and LANSS scores.

Results

Our study included 45(%90) female and 5(%10) male patients. The
mean age of the patients was 56.9 years. As a result of the detailed evaluation
and recording of the examination findings, 34 patients had lower extremity pain
(68%), 1 patient had neuropathic pain (2%), 21 patients had vascular pain
(42%), 24 patients had mechanical pain (48%).

Patients had a movement mean vas value of 5(0-7), a resting mean vas value of 0(0-3) and a nocturnal vas value of 0(0-0.5).

The average of the Lymphedema Life Impact Scale is 42.

According to these results, the most
common pain in patients with lower extremity lymphedema is mechanical pain
and lymphedema negatively affects the quality of life of patients.

Conclusions

Pain is common in patients with lower extremity lymphedema and
impairs quality of life. We suggest that a multidisciplinary approach may be
useful in making the diagnosis and initiating the treatment plan

References

1.Singh L, Stevens EE. Leg pain and gynecologic malignancy. Am J Hosp Palliat Care. 2013 Sep;30(6):594-600. doi: 10.1177/1049909112460422. Epub 2012 Sep 25. PMID: 23015730.

2.Rowlands IJ, Beesley VL, Janda M, Hayes SC, Obermair A, Quinn MA, Brand A, Leung Y, McQuire L, Webb PM; Australian National Endometrial Cancer Study Group. Quality of life of women with lower limb swelling or lymphedema 3-5 years following endometrial cancer. Gynecol Oncol. 2014 May;133(2):314-8. doi: 10.1016/j.ygyno.2014.03.003. Epub 2014 Mar 11. PMID: 24631452.

3.Biglia N, Zanfagnin V, Daniele A, Robba E, Bounous VE. Lower Body Lymphedema in Patients with Gynecologic Cancer. Anticancer Res. 2017 Aug;37(8):4005-4015. doi: 10.21873/anticanres.11785. PMID: 28739682.

4.Dessources K, Aviki E, Leitao MM Jr. Lower extremity lymphedema in patients with gynecologic malignancies. Int J Gynecol Cancer. 2020 Feb;30(2):252-260. doi: 10.1136/ijgc-2019-001032. Epub 2020 Jan 7. PMID: 31915136; PMCID: PMC7425841.

Presenting Author

Zeynep Senagunes

Poster Authors

Zeynep Sena GÜNE?

Ankara Bilkent City Hospital

Lead Author

Bilge KES?KBURUN

Ankara Bilkent City Hospital

Lead Author

Ay?e Merve ATA

Ankara Bilkent City Hospital

Lead Author

Meltem DALYAN

Ankara Bilkent City Hospital

Lead Author

P?nar BORMAN

Ankara Medipol University Medical Faculty Dept of PMR

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Pain in Chronic/Inflammatory Diseases