Post-Surgery Lymphatic Fluid Leakage After Endometrial Cancer

Surgery for endometrial cancer?

Hello, doctor.
A family member was recently diagnosed with early-stage endometrial cancer, and after evaluation, the physician decided to perform minimally invasive surgery to remove the uterus.
It has been about a week post-surgery, and she is still experiencing a significant amount of milky white fluid (approximately 1500cc per day) draining from the vaginal canal.
The surgeon mentioned that this is lymphatic fluid and is considered a normal phenomenon, but the volume is quite concerning.
Additionally, I found that lymphatic fluid is typically clear and colorless.
I couldn't find any literature indicating that there would be a large loss of lymphatic fluid post-surgery, so I would like to ask how to handle this situation.
It is distressing to see my family member becoming weaker each day.

Danxin de Z, 30~39 year old female. Ask Date: 2019/02/27

Dr. Huang Yuande reply Obstetrics and Gynecology

Thank you for your question.
After a hysterectomy, the vaginal cuff may develop granulation tissue or remnants of sutures, which can lead to increased discharge.
However, due to the possibility of cancer spread from the surgery, it is essential to have this evaluated and treated by your obstetrician-gynecologist.

Reply Date: 2019/02/27

More Info

After a minimally invasive surgery for early-stage endometrial cancer, it is not uncommon for patients to experience some degree of fluid leakage from the vaginal area. This can be particularly concerning when the volume of fluid is significant, as you described—around 1500cc per day. The fluid you are observing is likely lymphatic fluid, which can occur due to lymphatic disruption during surgery.
Lymphatic fluid is typically clear to pale yellow, but it can appear milky or cloudy if it contains a higher concentration of fat or other substances. The presence of a large volume of milky fluid can be alarming, especially when it deviates from the expected characteristics of lymphatic fluid. While the surgeon may have indicated that this is a normal phenomenon, it is essential to monitor the situation closely.

In the context of surgery for endometrial cancer, lymphatic leakage can occur if lymph nodes were removed or if there was significant manipulation of the lymphatic vessels during the procedure. This condition is known as lymphorrhea, and while it can be a normal postoperative occurrence, excessive leakage can lead to complications such as dehydration, electrolyte imbalances, and increased risk of infection.

Here are some steps to consider in managing this situation:
1. Monitoring: Keep a close eye on the volume and characteristics of the fluid. Document any changes in color, consistency, or volume. If the fluid becomes foul-smelling or if there are signs of infection (such as fever, increased pain, or redness), it is crucial to contact the healthcare provider immediately.

2. Hydration: Ensure that your family member stays well-hydrated, especially if they are losing a significant amount of fluid. This may involve oral hydration or, in some cases, intravenous fluids if dehydration becomes a concern.

3. Follow-Up: Schedule a follow-up appointment with the surgeon or oncologist to discuss the ongoing fluid leakage. They may want to perform an examination or imaging studies to assess the situation further. It is essential to communicate your concerns about the volume of fluid and any symptoms of weakness or fatigue.

4. Wound Care: If there are any surgical incisions, proper care should be taken to keep the area clean and dry. This can help prevent infection and promote healing.

5. Supportive Care: Encourage rest and provide emotional support during this recovery phase. Surgery can be physically and emotionally taxing, and your family member may need additional support as they heal.

6. Education: Educate yourself about the normal postoperative course for endometrial cancer surgeries. Understanding what to expect can help alleviate some anxiety and prepare you for discussions with healthcare providers.

In conclusion, while lymphatic fluid leakage can be a normal postoperative occurrence, the volume you described is concerning and warrants further evaluation. It is essential to maintain open communication with the healthcare team and advocate for your family member's health and well-being. If the situation does not improve or worsens, do not hesitate to seek immediate medical attention.

Similar Q&A

Understanding Lymphedema: Causes and Surgical Implications After Cancer Treatment

I know a grandmother who underwent a total hysterectomy and oophorectomy due to cervical cancer 20 years ago. Since then, her left leg has been swollen due to lymphatic obstruction. Since 1995, she has had five surgeries to improve this condition. I would like to ask: why does sh...

Dr. Lu Daokuan reply Plastic Surgery
Tumor surgery requires the removal of nearby lymph nodes to prevent the spread of cancer cells. If lymph nodes in the leg are removed, lymphatic fluid may not flow back to the trunk properly, leading to frequent swelling. Currently, there is a strong emphasis on early detection a...

Post-Surgery Swelling of Groin Lymph Nodes: Causes and Concerns

Hello Dr. Lee: I underwent a right thigh lymph node excision surgery two weeks ago, and the pathology results indicate stage II follicular lymphoma. Since the surgery, the wound has been very swollen (about the size of a duck egg), and it is quite painful when pressed or while wa...

Dr. Li Zhonghuai reply Surgery
Hello! After surgery on the lymph nodes, there may be lymphatic fluid leakage from the nearby lymphatic vessels, which can be more pronounced in cases of malignant lymph nodes. It is recommended to consult a hematologist-oncologist for the next phase of treatment as soon as possi...

Managing Lower Limb Edema After Uterine Tumor and Lymph Node Surgery

Hello! My mother-in-law had a uterine tumor removed along with lymph nodes over ten years ago. Since then, she has experienced severe lower limb edema periodically, requiring diuretics to alleviate the symptoms. I would like to ask Dr. Tsai if my mother-in-law will have to deal w...

Dr. Cai Yonglong reply Obstetrics and Gynecology
Dear Dr. Tsai Yong-long of the Department of Obstetrics and Gynecology at Tainan Hospital, Ministry of Health and Welfare, The lower limb edema following a hysterectomy with lymphadenectomy is attributed to poor venous return and impaired lymphatic circulation. In addition to th...

Understanding Post-Surgery Drainage After Breast Cancer Surgery

Hello, Director Tang. I would like to ask you a question. My mother previously underwent surgery for breast cancer and was readmitted due to inflammation that caused a large amount of yellow fluid to drain. She has been home for 9 days now, but the wound continues to discharge a ...

Dr. Tang Yuxiong reply Surgery
Hello, Miss Xiao Zi. Based on your description, it appears to be normal tissue fluid. It is advisable to simply observe the situation, keeping the wound clean and monitoring for any signs of redness, swelling, heat, or pain. If any abnormalities occur, you should return for a fol...