Lymphedema

Lymphedema or lymphostasis is an edema, a visible and palpable accumulation of fluid in the intercellular space, which describes a symptom rather than a disease itself. Lymphedema is an accumulation of fluid caused by insufficiency of the lymphatic vessels. The clinical picture is chronic inflammatory, and affected areas may include not only the extremities but also the face, neck, trunk, and even the genitals. Due to mechanical insufficiency in the lymphatic vessels, intercellular fluid cannot be adequately drained from the tissues, leading to back pressure and concentration of fluid in the intercellular space.

Stages

Stage 0: Latent stage, symptoms have not yet manifested

Stage 1: Reversible stage, the edema contains much protein, and only small, few, locally limited fibrosclerotic tissue changes are present. The edema is still doughy soft, and a 'dimple' can be relatively easily made with a finger. The swelling can be reduced by positioning the affected body part as high as possible. Stemmer's sign is usually positive.

Stage 2: Spontaneously irreversible stage, during this stage fibrosclerotic changes and proliferation of fatty tissues occur. The edema feels hard and no longer responds to decreased swelling when the affected body part is positioned in a high position.

Stage 3: Elephantiasis stage; extensive fibrosclerotic changes and proliferations of fatty tissues have occurred.

Therapy

When choosing therapy to remove excess fluid from the intercellular space, complex physical therapy is most often considered, which includes:

- manual lymphatic drainage

- skin care

- compression bandages and stockings

- special kinesitherapy (gymnastics) for compression

Such therapy has long proven itself as the most successful in fighting lymphedema. Sometimes careful treatment with small doses of diuretics (dehydrating agents) is also used. Long-term use is unjustified, because then a yo-yo effect can be observed in the edematous state, and to prevent the edema from increasing again after using such drugs, their dose needs to be increased each time, which is unacceptable for the body.