An inguinal lymph node dissection is a surgical procedure to remove lymph nodes in the groin. These nodes are part of the lymphatic system, which helps filter waste and germs from the body. The surgery is most often performed to determine if cancer from the lower body or genitals has spread, or to remove nodes that are already cancerous.
Cancers originating in the penis, vulva, anus, or skin on the legs and torso tend to drain to these nodes first. Examining them helps doctors understand the extent of the cancer and guide further treatment decisions.
Chronic Swelling (Lymphedema)
One of the most common long-term consequences of removing groin lymph nodes is a condition called lymphedema. This occurs because the surgery disrupts the lymphatic system’s pathways for moving fluid from tissues. Without the nodes to help manage this fluid, it can accumulate in the soft tissues of the leg, groin, or genital area, leading to persistent swelling. This condition affects a significant portion of patients, with some studies suggesting it occurs in 20-30% of individuals who undergo the operation.
The development of lymphedema is not always immediate and can manifest months or even years after the procedure. Lymphedema is a chronic issue, unlike the temporary swelling common after surgery. The initial signs can be subtle, such as a feeling of heaviness or tightness in the limb, followed by more obvious swelling that does not resolve with elevation. The skin may feel tight, and clothing or shoes may fit differently on the affected side.
As lymphedema progresses, the swelling might be soft in the early stages and may decrease overnight. Without management, the tissue can become more dense and fibrous, making the swelling firm and persistent. This chronic fluid buildup can impact mobility and make the limb feel heavy and uncomfortable, creating functional challenges.
Nerve Damage and Altered Sensation
During an inguinal lymph node dissection, surgeons may need to cut or move small nerves in the groin area. This can lead to lasting sensory changes in the skin of the upper thigh and groin. Because the procedure requires removing tissue containing these nerves, some degree of sensory alteration is a common outcome.
A frequent side effect is numbness in the region of the inner thigh and around the surgical scar. While disconcerting, many people adjust to this change over time. Alongside numbness, some individuals experience paresthesia, which is characterized by tingling or “pins and needles” sensations from nerve irritation or recovery.
In some cases, nerve-related issues can lead to chronic neuropathic pain, which is different from initial post-operative discomfort. This can manifest as a persistent burning feeling or sharp, shooting pains in the leg or groin. Managing this type of long-term pain often requires specific medical evaluation and treatment, as it does not respond to standard pain relievers.
Increased Risk of Infection
Lymph nodes act as filters that trap pathogens like bacteria. When the inguinal lymph nodes are removed, this filtration capacity is diminished in the corresponding leg, leaving it more vulnerable to infections. The fluid-rich environment created by lymphedema can further elevate this risk by providing an ideal setting for bacteria to multiply.
A primary concern is a bacterial skin infection called cellulitis, which affects the deeper layers of the skin and can have a rapid onset. Signs include redness that may spread, skin that is warm to the touch, and significant swelling. The area is often painful and may be accompanied by fever or a general feeling of being unwell.
Because local immune defenses are weakened, even a small break in the skin on the affected leg can introduce bacteria and lead to a serious infection. Prompt medical attention is necessary for antibiotic treatment to prevent the infection from spreading.
Strategies for Management and Care
For lymphedema, a primary component of care is Complete Decongestive Therapy, a program supervised by a certified lymphedema therapist. This therapy integrates techniques like manual lymphatic drainage, a specialized massage to redirect fluid, and multi-layer compression bandages to reduce swelling. Following therapy, patients often wear custom-fitted compression garments daily to maintain the reduction in limb size.
Preventing infection requires careful attention to skin health on the affected leg.
- Keep the skin clean and well-moisturized to prevent cracking.
- Use careful nail care to avoid accidental cuts.
- Clean any minor injury, like a scrape or insect bite, immediately and monitor it closely.
- Avoid needle sticks for blood draws or injections in the affected limb.
For chronic neuropathic pain, medications designed to calm overactive nerves may be prescribed. Lifestyle measures can also help. Maintaining a healthy body weight reduces strain on the lymphatic system, while regular, gentle exercise like walking or swimming helps promote fluid movement without overtaxing the limb.