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Large fluid retention after RARP

Prostate Cancer | Last Active: 6 days ago | Replies (10)

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It is really too bad it got dragged out. A lymphocele is one of the known risks after RARP, if samples of lymph nodes are taken. You would think that would be the first thing to come to mind for a urologist, or even another MD after knowing you had RARP surgery.

"A lymphocele is a collection of lymphatic fluid in a body cavity, typically occurring after surgery or trauma that disrupts the lymphatic system. A lymphocele forms when lymphatic vessels are damaged or disrupted, causing lymph fluid to accumulate in a space within the body that is not lined by epithelium, unlike a true cyst or tumor (Wikipedia). It is most commonly seen after surgical procedures such as pelvic lymph node removal..."

My surgeon explained that when they remove lymph nodes during a RARP, they do not cauterize them or sew them shut. I envision a garden hose waiving around spewing lymph fluid. Normally the lymph fluid keeps draining and does not form a pocket. Some surgeons install a drain after surgery, mine does not. So, in my case lymph fluid built up in a pocket in my abdomen, started crushing my bladder (and some nerves) and got infected. By your description it sounds like the same happened to you.

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Replies to "It is really too bad it got dragged out. A lymphocele is one of the known..."

@jim1961 I am pretty sure I have a lymphocele. I am still draining an average of over 450cc per day 9 days after drain placed. Did your surgeon discuss what techniques are available if it does not stop draining on its own? My surgeon says the Interventional Radiation team usually “scleroses” the pelvic area with a liquid that seals the leaking lymphocele. I have also heard of two other treatments. One is called lymphatic embolization, and the other is called laparoscopic “unroofing” that directs the drainage into the perineal cavity. Has anyone heard of the different methods to treat lymphoceles that continue to drain?