Leg swelling after uterine cancer surgery can occur due to disruption of the lymphatic system during treatment. In many cases, procedures such as lymph node removal (lymphadenectomy) or radiation therapy in the pelvic area may damage or block lymphatic vessels, preventing proper fluid drainage. This can lead to fluid buildup known as lymphedema, a chronic swelling condition that commonly appears in the legs or groin.
To address this condition, RS Mandaya Puri provides a dedicated Lymphedema Center offering comprehensive care, ranging from lymphatic bypass procedures to rehabilitation with advanced compression devices to help reduce swelling and improve patients’ quality of life.
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Causes of Leg Swelling After Uterine Cancer Surgery
Uterine cancer surgery is typically performed to remove cancerous tissue and prevent the spread of the disease to other organs. In many cases, this procedure also involves the removal of lymph nodes as part of cancer staging.
However, this intervention can affect the lymphatic system, which plays a key role in fluid circulation, potentially leading to lymphedema or leg swelling.
Some of the main causes and risk factors include:
- Lymph Node Removal: This procedure is commonly performed in endometrial cancer to assess cancer spread. However, removing lymph nodes in the pelvic or para-aortic area can eliminate the natural “drainage system” for lymphatic fluid, leading to fluid buildup and swelling.
- Radiation Therapy: Radiation treatment in the pelvic area can damage remaining lymphatic vessels, causing scar tissue that blocks fluid flow and increases the risk of lymphedema.
- Disease Progression: In some cases, the tumor itself or cancer recurrence may compress or obstruct lymphatic vessels, disrupting fluid flow and causing swelling in the legs.
Signs and Symptoms of Lymphedema
The most common sign of lymphedema is swelling, which may develop gradually and go unnoticed in the early stages, or appear suddenly. Other symptoms may include:
- Veins or tendons in the hands and feet become difficult to see or feel
- Arms or legs appear to be different sizes
- Joints feel stiff or less flexible
- Skin appears swollen or reddish
- Swelling in the arms, legs, or other parts of the body
- A feeling of heaviness or fullness in the affected area
- Clothes or jewelry feel tighter than usual
- A burning or itching sensation
- Skin becomes noticeably thicker
Management of Leg Swelling After Uterine Cancer Surgery at RS Mandaya Puri
Treatment for leg swelling after uterine cancer surgery at the Lymphedema Center of RS Mandaya Royal Puri is carried out comprehensively through a multidisciplinary approach. The team consists of plastic reconstructive and aesthetic surgeons with subspecialty in microsurgical reconstruction and oncoplastic surgery, working alongside physical medicine and rehabilitation specialists and trained nurses to provide integrated and personalized care.
1. Lymphatic Bypass Procedure
One of the main treatment options for lymphedema at the Lymphedema Center is the lymphatic bypass procedure. This procedure is intended for patients experiencing swelling due to impaired lymphatic flow, with the goal of creating a new pathway for fluid drainage.
According to dr. Sara Ester Triatmoko, Sp.B.P.R.E., Subsp.M.O. (K), a plastic reconstructive and aesthetic surgeon with subspecialty in microsurgical reconstruction and oncoplastic surgery at RS Mandaya Puri, patients who begin to experience swelling after uterine cancer surgery are encouraged to seek early medical evaluation. The procedure involves connecting lymphatic vessels to small blood vessels (venules), allowing previously obstructed lymph fluid to flow again.
This technique utilizes high-precision supermicrosurgery. To support accuracy, the procedure is performed using the advanced Kinevo 900 microscope, which enables detailed visualization of extremely small vessels. Before surgery, lymphatic mapping is performed using contrast agents to identify affected areas and determine the optimal bypass points.
The impaired lymphatic vessels are then connected to venules to create a new pathway, allowing lymph fluid to drain directly into the venous system. This significantly helps reduce swelling.
This procedure is known as Lymphaticovenular Anastomosis (LVA), a minimally invasive technique designed to treat lymphedema by redirecting lymphatic flow into nearby small veins.
2. Rehabilitation
After undergoing the lymphatic bypass procedure, patients typically continue therapy with the rehabilitation team to optimize treatment outcomes. One commonly used method is compression devices, which are pneumatic pumps that apply alternating pressure to swollen areas.
These devices are used with special sleeves worn on the legs. The generated pressure helps maintain smooth lymphatic and venous circulation while preventing fluid buildup.
In addition to reducing swelling, compression pump therapy also helps lower the risk of lymphedema-related complications and supports overall recovery.
Medical Team at the Lymphedema Center, RS Mandaya Royal Puri
Lymphedema care at RS Mandaya Royal Puri is supported by experienced medical professionals from various specialties, ensuring comprehensive and personalized treatment for each patient. The team includes:
1. dr. Sara Ester Triatmoko, Sp.B.P.R.E., Subsp.M.O. (K)
A plastic reconstructive and aesthetic surgeon with subspecialty in microsurgical reconstruction and oncoplastic surgery. Her work focuses not only on aesthetics but also on restoring body function, including post-cancer reconstruction, trauma repair, burn treatment, and correction of congenital conditions. With precise microsurgical techniques, her procedures aim to improve both physical structure and overall quality of life.
Schedule:
- Tuesday & Thursday: 17:00 – 19:30 WIB
2. dr. Andre Sugiyono, Sp.KFR
A Physical Medicine and Rehabilitation specialist trained at Atma Jaya Catholic University and the University of Indonesia. His expertise includes electrotherapy, physiotherapy, hydrotherapy, and post-stroke rehabilitation, focusing on restoring function and improving patients’ quality of life.
Schedule:
- Monday – Friday: 08:30 – 15:30 WIB
- Saturday: 14:30 – 19:00 WIB
3. dr. Eugene Nathania, Sp.KFR
A Physical Medicine and Rehabilitation specialist from the University of Indonesia. She is skilled in various therapeutic techniques such as obstetric rehabilitation, taping, manual therapy, and dry needling, and has experience in managing musculoskeletal pain and restoring mobility.
Schedule:
- Monday – Saturday: 08:00 – 14:00 WIB
4. dr. Johanes Putra, Sp.KFR
A Physical Medicine and Rehabilitation specialist trained at Atma Jaya University and the University of Indonesia. He specializes in musculoskeletal rehabilitation and interventional pain management to effectively relieve patient discomfort.
Schedule:
- Monday – Friday: 14:30 – 20:00 WIB
- Saturday: 08:00 – 14:00 WIB
In addition to specialist doctors, lymphedema services at RS Mandaya Royal Puri are also supported by trained and experienced nursing staff, ensuring patients receive optimal, comprehensive, and integrated care.
To make your visit more convenient, patients can use WhatsApp Chat, Book Appointment, or the Care Dokter app available on Google Play and the App Store. These services allow patients to schedule consultations, check queue numbers, and access important hospital information.
The information provided on this page is for educational purposes and general reference only and does not represent the full range of medical services available. For appropriate diagnosis and treatment, please consult directly with a qualified doctor.
If you have any questions, suggestions, or need further information, please contact our call center at 0811-1900-2000.
