Innovative microsurgical treatment of male external genitals lymphedema

Figure 4 Photodynamic eye lymphography performed at three months after lympho-venous shunt of the the spermatic cord in a patient affected by lymphedema of the lower limb and of the external genitals secondary to radical prostatectomy and lymphadenectomy of the pelvic-inguinal lymph-nodes chain. After injection (bright spot, A) in the scrotum, fluorescent indocyanine travels along a lymphatic vessel (arrows) in the thigh to connect with the lymphatic network of the lower limb (B). After injection in the foot, indocyanine flows along the lower limb lymphatics vessels (B and C) to be shunted directly into the external genitals lymphatic plexus (D and E) bypassing the excised pelvic-inguinal lymph-nodes chain.