The prognosis of primary lymphedema of the lower limbs
J. H. Wolfe and J. B. Kinmonth
Primary lymphedema in most patients can be managed conservatively, but, in
a few, severe lymphedema develops that requires surgical reduction of the
limb. The five- to 20-year course of the disease has been studied in 372
patients. The eventual extent of the disease could be assessed within the
first year. Further spreading of the lymphedema in the same limb occurred
in only 7% of the patients after the first year and in less than 1% after
five years. Only 9% of the patients suffered lymphedema of the other leg at
a later time. Patients without pelvic lymphatic obstruction had a good
prognosis even if the distal lymphatics were obliterated, but 32% of those
with proximal obstructive hypoplasia had severe lymphedema that required
surgical reduction. In this latter group, men and women were affected
equally.
