{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:41:26Z","timestamp":1785800486417,"version":"3.56.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lymphedema in the lower abdomen and genitals is unnoticeable and has no established diagnostic methods. In this study, we evaluated it using four examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We evaluated 25 patients with lymphedema in the legs, dividing the abdomen and genitals in four areas (right and left, upper and lower). The mean age was 58.6 years. In lymphoscintigraphy and indocyanine green (ICG) lymphography, we diagnosed lymphedema when dermal backflow was observed. ICG lymphography was performed in 13 patients. In ultrasonography, we determined the presence of edema when cobblestone pattern was observed. Subcutaneous fat thickness was also measured. The patients\u2019 subjective symptoms were identified on an interview. We compared the results among the examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The positivity rates for lymphedema based on lymphoscintigraphy, ICG lymphography, ultrasonography, and subjective symptoms were 45.0%, 42.3%, 8.0%, and 34.0%, respectively. Two of the 13 patients who underwent all examinations complained of subjective symptoms of edema in areas that showed no abnormalities in the examinations. In contrast, 14 of the 25 patients had areas where they had no subjective symptoms despite having abnormalities in at least one of the tests. Those with subjective symptoms of edema tended to have thinner abdominal fat in both the upper and lower abdomen, but no significant difference was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Large differences were observed in the positive rate of edema in subjective symptoms and examinations of lymphedema in the lower abdomen and genitals. It is not important to determine which examination is best but rather to combine multiple examinations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2024.0032","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T10:34:42Z","timestamp":1727260482000},"page":"261-266","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnosis of Lymphedema and Subjective Symptoms in the Lower Abdomen and Genital Region"],"prefix":"10.1177","volume":"22","author":[{"given":"Hisako","family":"Hara","sequence":"first","affiliation":[{"name":"Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Mihara","sequence":"additional","affiliation":[{"name":"Department of Lymphatic Surgery, Lymphedema Clinic, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"issue":"1","key":"e_1_3_4_2_2","first-page":"3","article-title":"The diagnosis and treatment of peripheral lymphedema: 2020 consensus document of the international society of lymphology","volume":"53","author":"Executive Committee of the International Society of Lymphology.","year":"2020","unstructured":"Executive Committee of the International Society of Lymphology.. The diagnosis and treatment of peripheral lymphedema: 2020 consensus document of the international society of lymphology. Lymphology, 2020; 53(1):3\u201319.","journal-title":"Lymphology"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2017.0025"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0016"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2018.0069"},{"issue":"10","key":"e_1_3_4_6_2","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.bjps.2013.05.030","article-title":"Anatomy of the superficial lymphatics of the abdominal wall and the upper thigh and its implications in lymphatic microsurgery","volume":"66","author":"Tourani SS","year":"2013","unstructured":"Tourani SS, , Taylor GI, , Ashton MW. Anatomy of the superficial lymphatics of the abdominal wall and the upper thigh and its implications in lymphatic microsurgery. J Plast Reconstr Aesthet Surg, 2013; 66(10):1390\u20131395.","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"10","key":"e_1_3_4_7_2","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.12968\/bjcn.2019.24.Sup10.S19","article-title":"Are you handling genital oedema confidently","volume":"24","author":"Noble-Jones R","year":"2019","unstructured":"Noble-Jones R, , Thomas MJ, , Davies L, et al. Are you handling genital oedema confidently? Br J Community Nurs, 2019; 24(Sup 10):S19\u2013S22.","journal-title":"Br J Community Nurs"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20772"},{"issue":"5","key":"e_1_3_4_9_2","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1097\/SAP.0000000000001872","article-title":"Postoperative changes in lymphoscintigraphic findings after lymphaticovenous anastomosis","volume":"83","author":"Hara H","year":"2019","unstructured":"Hara H, , Mihara M. Postoperative changes in lymphoscintigraphic findings after lymphaticovenous anastomosis. 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Assessment of the lymphatic system of the genitalia using magnetic resonance lymphography before and after treatment of male genital lymphedema. Medicine (Baltimore), 2016; 95(21):e3755.","journal-title":"Medicine (Baltimore)"},{"issue":"6","key":"e_1_3_4_22_2","doi-asserted-by":"crossref","DOI":"10.1016\/j.bjps.2014.02.018","article-title":"MR lymphangiography for the assessment of the lymphatic system in a primary penoscrotal lymphedema patient undergoing surgical management","volume":"67","author":"Jiang Z","year":"2014","unstructured":"Jiang Z, , Cao W, , Kretlow JD, et al. MR lymphangiography for the assessment of the lymphatic system in a primary penoscrotal lymphedema patient undergoing surgical management. 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Eur Rev Med Pharmacol Sci, 2017; 21(4):674\u2013679.","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"10","key":"e_1_3_4_26_2","doi-asserted-by":"crossref","first-page":"2872","DOI":"10.3390\/jcm13102872","article-title":"Combination of supramicrosurgical lymphatico-venular anastomosis (slva) and lymph-sparing liposuction in treating cancer-related lymphedema: Rationale for a regional one-stage approach","volume":"13","author":"Gabriele G","year":"2024","unstructured":"Gabriele G, , Nigri A, , Chisci G, et al. Combination of supramicrosurgical lymphatico-venular anastomosis (slva) and lymph-sparing liposuction in treating cancer-related lymphedema: Rationale for a regional one-stage approach. J Clin Med, 2024; 13(10):2872.","journal-title":"J Clin Med"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30689"},{"issue":"1","key":"e_1_3_4_28_2","doi-asserted-by":"crossref","first-page":"znad372","DOI":"10.1093\/bjs\/znad372","article-title":"Lymphatic venous anastomosis and complex decongestive therapy for lymphoedema: Randomized clinical trial","volume":"111","author":"Mihara M","year":"2024","unstructured":"Mihara M, , Hara H, , Kawasaki Y, et al. Lymphatic venous anastomosis and complex decongestive therapy for lymphoedema: Randomized clinical trial. 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