Volume 60, Issue 5, Pages (November 2011)

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Volume 60, Issue 5, Pages 1114-1119 (November 2011) Assessment and Follow-Up of Patency After Lymphovenous Microsurgery for Treatment of Secondary Lymphedema in External Male Genital Organs Sylvain M. Mukenge, Marco Catena, Daniela Negrini, Francesca Ratti, Andrea Moriondo, Alberto Briganti, Patrizio Rigatti, Federica Cipriani, Gianfranco Ferla European Urology Volume 60, Issue 5, Pages 1114-1119 (November 2011) DOI: 10.1016/j.eururo.2010.11.020 Copyright © 2010 European Association of Urology Terms and Conditions

Fig. 1 (A) Surgical set-up; (B) lymphatic duct (at white arrow); (C) vein almost prepared for anastomosis (at white arrow); (D) lymphatic duct (white arrow), anastomosis between lymphatic duct and vein shown in panel C (black arrow); (E) other testicle, lymphatic duct, and vein paired before anastomosis; (F) photo taken early during lymphatic vein anastomosis shown in panel E (black arrow). Surgical rope and needle are visible passing through the anastomosis point. European Urology 2011 60, 1114-1119DOI: (10.1016/j.eururo.2010.11.020) Copyright © 2010 European Association of Urology Terms and Conditions

Fig. 2 Main panel: infrared fluorescence composite view of three different images encompassing the whole lymphatic network visualised by indocyanine green injection into the subcutaneous tissue at the base of the scrotum. White arrowheads indicate lymphatic vein anastomosis sites where indocyanine green is drained by the blood flow and thus no longer visible. Scale bar: 3cm. Inset panel: magnified and digitally enhanced still photo of the lymphatic network of the testicle shown in the main panel. European Urology 2011 60, 1114-1119DOI: (10.1016/j.eururo.2010.11.020) Copyright © 2010 European Association of Urology Terms and Conditions

Fig. 3 Postoperative percentage improvement, with respect to the preoperative condition, of scrotal edema volume, scrotal weight sensation, and urination from patients’ self-evaluations at 8.8 mo after scrotal microsurgery. European Urology 2011 60, 1114-1119DOI: (10.1016/j.eururo.2010.11.020) Copyright © 2010 European Association of Urology Terms and Conditions

Fig. 4 Plot of time to resolution (TTR), in months, from lymphatic derivation surgery versus patient age (years) and superimposed linear fit to the data. European Urology 2011 60, 1114-1119DOI: (10.1016/j.eururo.2010.11.020) Copyright © 2010 European Association of Urology Terms and Conditions

Fig. 5 (A) Preoperative scrotal edema; (B) postoperative edema reduction at 3 yr after surgery. European Urology 2011 60, 1114-1119DOI: (10.1016/j.eururo.2010.11.020) Copyright © 2010 European Association of Urology Terms and Conditions