Swollen legs or genitals (lymphoedema) and penile cancer
Some people get swelling in one or both legs after radiotherapy or surgery to the lymph nodes in the groin and pelvis. Sometimes swelling can also be in the lower part of the tummy (abdomen), penis or sac of skin around the testicles (the scrotum).
This swelling is called lymphoedema (lim-fo-dee-ma).
The lymph nodes are part of your body's drainage system. If you have had lymph nodes removed from your groin, this can affect the natural circulation and drainage of tissue fluid from the leg on that side.
Pain and heaviness
Lymphoedema can be uncomfortable and sometimes painful. Swelling that causes pressure on nerves can cause pain. If your leg is heavy, it can cause problems with walking and your posture. This can cause pain in your joints or other parts of the body.
Lymphoedema is easier to manage as soon as any signs of swelling appear. If you see any swelling in your feet, legs, tummy or genitals speak to your GP or doctor at the hospital. They can refer you to a lymphoedema specialist.
The British Lymphology Society (BLS) has a register of UK lymphoedema practitioners.
Treatment for lymphoedema
There are different types of treatment to reduce lymphoedema. This includes compression therapy and manual lymphatic drainage (MLD).
Unfortunately, lymphoedema can’t be cured, but can usually be well managed with treatment. The aim of treatment is to:
- control and reduce the swelling when possible
- look after your skin and reduce the risk of problems, such as infection
- help you to live as normally as possible
Compression therapy
Compression therapy is an important part of treatment. It works by putting pressure on the area of swelling and encourages the movement of lymph fluid around the lymph vessels. The pressure needs to be even but firm in the swollen area.
There are different ways to apply compression. They include compression bandaging and compression garments.
Manual lymphatic drainage (MLD)
Manual lymphatic drainage is a way of reducing swelling caused by fluid build up after cancer treatment.
The aim of MLD is to move fluid from the swollen area into a place where the lymphatic system is working normally. This must only be performed by a specialist trained to do this.
Exercises for lymphoedema
We know from research that exercise helps lymph move through the lymphatic system. This might help reduce swelling. Exercise makes the muscles contract and pushes lymph through the lymph vessels.
Exercises have other benefits. They can help you to keep a full range of movement and make you feel better.
Your physiotherapist or nurse will show you some exercises you can do at home if you have lymphoedema.
Below are 2 videos that can help you with these exercises. Both are by a physiotherapist called Carla from the lymphoedema team at University College Hospital London. Speak to your doctor or lymphoedema specialist if you are unsure about doing any of them.
The first video shows you how to do breathing exercises. The second video shows you how to do leg exercises. It is important to do the breathing exercises before and after the leg exercises.
These exercises should not be painful, so you must stop them if you have any pain. If the pain doesn't get better contact your doctor. Do each exercise slowly and gently, and it may help to rest in between.
The video about deep breathing exercises is 1 minute long.
Hi I’m Carla, I’m going to show you how to do deep abdominal breathing. Remember to have a nice posture, relaxed shoulders. You can do them sitting down or standing up. Remember to breathe in by nose and breathe out by mouth.
So, when you breathe in, imagine you have a balloon in your tummy and you inflate this balloon and when you breathe out, imagine you’re deflating this balloon. You need to feel your hand going in so we’ll do it together now. We’ll breathe in…. and out.
Remember to do them a maximum five times and before and after you do your lymphoedema exercises.
Watch our videos for the exercises of the area where you have lymphoedema or you’re at risk of lymphoedema.
The video about leg exercises is just over 4 minutes long.
Hi, I’m Carla. I’m going to show you how to do leg exercises. Remember before you start to do your deep abdominal breathing exercises before and after. And repeat each exercise 5 to 10 times. Remember they need to be all pain free.
Upper leg exercises
We’ll start marching on the spot. Very gently. And then if possible go as high with your knees as you can. If you need help with your balance, hold on to a stable surface and again do some marching on the spot gently and as high as you can go.
Next one will be heels to bottom and again if you feel you need a bit of help with your balance, hold on to a stable surface.
Hip exercises
Next one will be working with the hips, rotating. We’ll be bringing our foot forward and drawing a semi-circle. This knee needs to be bent slightly and if you can, you will lift your foot a bit from the ground. If you need a bit of help with your balance, we’ll do it holding on to a stable surface. We’ll do the same drawing a semi-circle on the floor and if possible, lifting the foot a bit.
Next exercise we’ll do touching the knee with the opposite hand and if you need help with your balance instead of alternating we’ll do first one side and then don’t forget to do the other leg.
Knee exercises
For the knee we’ll need to sit down on a chair. We’ll do marching on the spot. You can use your arms, or you can have your arms on your lap.
We’ll be extending and bending the knees. If you have a bit of a problem with pain, you can do it a bit lower.
Ankle exercises
Next one we’ll be focusing on the ankle. We’ll do heel up and down as much as possible. Up and slowly going down to the floor.
Next one will be toes up.
And to finish, we’ll focus on the ankle. This one you can do sitting down on a recliner chair or on a bed. What you’ll do is go up and down as much as possible. And you’ll do one leg and then the other. Or if you’re on the bed or on the recliner chair, you can do it both at the same time.
And then we’ll do circles and as much as possible looking for all the positions of the foot. One direction and then the other.
Remember to do all the exercises once a day and if you have any concerns just speak to your doctor or your lymphoedema specialist.
And remember that you have more information about lymphoedema on the Cancer Research UK website.
Emotional effects
For many people having lymphoedema can be a difficult side effect to cope with. You might feel upset or very sad when you get swelling. These feelings are natural. Talking to a lymphoedema therapist can help you to cope with the changes that you have.
You can also contact a support organisation like the Lymphoedema Support Network (LSN).
Lowering your risk of swelling and managing it
The risk of getting swelling (lymphoedema) lasts for life after treatment to your lymph nodes. It can come on years after your treatment.
You can help to lower your risk of swelling by not getting any skin infections. Infections trigger swelling in the area and that can cause more swelling in the leg.
A lymphoedema specialist can help you manage the lymphoedema, as well as give you advice and emotional support.
