OBJECTIVES To explore men's onset and burden of lower limb lymphedema (LLL) after radical prostatectomy (RP) with pelvic lymph node dissection (PLND). PATIENTS AND METHODS A cross-sectional survey-based study was conducted nation-wide and web-based in Germany. Part 1 included 15 multidisciplinary compiled questions with three questions from the Short Form 12 Health Survey (SF-12) and the WHO activity recommendation and part 2 included the validated German Lymph-ICF-Questionnaire (Lymph-ICF-LL). Subgroup comparisons and simple regression analyses were used to identify factors associated with therapy and burden of LLL, followed by multiple regression analyses to explain variance in impairment in the patients' daily life. RESULTS Fifty-four patients completed the survey. Median time of LLL-onset was reported with 2.0 (0.5-9.75) months after RP. Nineteen patients (35.2%) reported bilateral lymphedema, 28 (51.9%) the use of individually fitted compression stockings (CS), 25 (46.3%) of manual lymphatic drainage (LD), and 26 (48.1%) complete regression. The Lymph-ICF-LL revealed a higher total burden for patients with an active LLL compared to complete regression (total score: 25.5 vs. 11.9, p = 0.01) especially for "physical function" (28.3 vs. 12.9, p < 0.01) and "mental function" (26.2 vs. 6.7, p < 0.01). In multiple linear regression analysis, a higher BMI (β = 0.28), lower subjective general health (β = -0.48), and active lymphedema (β = 0.28) were significant predictors of higher reported impairments in the Lymph-ICF-LL, accounting for 45.4% of variance. CONCLUSION Men with LLL after RP with PLND report a significant burden in daily life. Basic therapy needs to be offered early. Postoperative onset of LLL is variable, which should be considered when assessing complications after RP.

中文翻译：

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根治性前列腺切除术后下肢淋巴水肿的发病和负担：一项横断面研究。

目的探讨男性在盆腔淋巴结清扫术（PLND）根治性前列腺切除术（RP）后下肢淋巴水肿（LLL）的发病和负担。患者和方法 一项基于横断面调查的研究在德国进行了全国性和基于网络的研究。第 1 部分包括 15 个多学科汇编问题，其中三个问题来自简表 12 健康调查 (SF-12) 和 WHO 活动建议，第 2 部分包括经过验证的德国淋巴-ICF-问卷 (Lymph-ICF-LL)。亚组比较和简单回归分析用于确定与治疗和 LLL 负担相关的因素，然后进行多元回归分析以解释患者日常生活损害的差异。结果 54 名患者完成了调查。LLL 发作的中位时间报告为 2.0 (0.5-9. 75) RP 后几个月。19 名患者（35.2%）报告双侧淋巴水肿，28 名（51.9%）使用单独安装的压力袜（CS），25 名（46.3%）手动淋巴引流（LD），26 名（48.1%）完全消退。Lymph-ICF-LL 显示活动性 LLL 患者的总负担高于完全消退（总分：25.5 vs. 11.9，p = 0.01），尤其是“身体功能”（28.3 vs. 12.9，p < 0.01）和“心理功能”（26.2 对 6.7，p < 0.01）。在多元线性回归分析中，较高的 BMI (β = 0.28)、较低的主观总体健康状况 (β = -0.48) 和活动性淋巴水肿 (β = 0.28) 是报告的 Lymph-ICF-LL 损伤较高的重要预测因素，占为 45.4% 的方差。结论 患有 PLND 的 RP 后患有 LLL 的男性报告了日常生活中的重大负担。需要及早提供基础治疗。LLL 的术后发作是可变的，在评估 RP 后的并发症时应考虑到这一点。