Urogenit Tract Infect.  2017 Dec;12(3):134-136. 10.14777/uti.2017.12.3.134.

Infected Lymphocele Extending to the Leg after Robot-Assisted Radical Prostatectomy and Pelvic Lymph Node Dissection

• Jung HJ

• KMID: 2400223
• DOI: http://doi.org/10.14777/uti.2017.12.3.134

Abstract

Lymphocele infection is a rare complication after radical prostatectomy and pelvic lymph node dissection (PLND). Here, we present a case of lymphocele infection that extended to the leg two months after robot-assisted laparoscopic radical prostatectomy and PLND. The patient was a 60-year-old man whose chief complaints were fever, chills, and right thigh pain. Computed tomography showed infected lymphocele with right thigh abscess. After percutaneous drainage and intravenous antibiotics, the infection and right thigh abscess were resolved.

Keyword

Lymphocele; Infection; Abscess; Prostatic neoplasms; Lymph node excision

MeSH Terms

Abscess
Anti-Bacterial Agents
Chills
Drainage
Fever
Humans
Leg*
Lymph Node Excision*
Lymph Nodes*
Lymphocele*
Middle Aged
Prostatectomy*
Prostatic Neoplasms
Thigh
Anti-Bacterial Agents

Figure

• 

  Fig. 1 Computed tomography scan indicating infected lymphocele and right leg abscess. A: leg abscess, B: urinary bladder, L: lymphocele.

• 

  Fig. 2 Computed tomography scan indicating decreased size of both the right leg abscess and infected lymphocele. The arrow indicates percutaneous drainage catheter. A: leg abscess, B: urinary bladder.

Reference

1. Solberg A, Angelsen A, Bergan U, Haugen OA, Viset T, Klepp O. Frequency of lymphoceles after open and laparoscopic pelvic lymph node dissection in patients with prostate cancer. Scand J Urol Nephrol. 2003; 37:218–221.

2. Ploussard G, Briganti A, de la Taille A, Haese A, Heidenreich A, Menon M, et al. Pelvic lymph node dissection during robotassisted radical prostatectomy: efficacy, limitations, and complications-a systematic review of the literature. Eur Urol. 2014; 65:7–16.

3. Aus G, Abbou CC, Bolla M, Heidenreich A, Schmid HP, van Poppel H, et al. EAU guidelines on prostate cancer. Eur Urol. 2005; 48:546–551.

4. Stewart SB, Boorjian SA. Radical prostatectomy in high-risk and locally advanced prostate cancer: Mayo Clinic perspective. Urol Oncol. 2015; 33:235–244.

5. Briganti A, Chun FK, Salonia A, Suardi N, Gallina A, Da Pozzo LF, et al. Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer. Eur Urol. 2006; 50:1006–1013.

6. Musch M, Klevecka V, Roggenbuck U, Kroepfl D. Complications of pelvic lymphadenectomy in 1,380 patients undergoing radical retropubic prostatectomy between 1993 and 2006. J Urol. 2008; 179:923–928. discussion 928-9.

7. Treiyer A, Haben B, Stark E, Breitling P, Steffens J. Uni- vs. multiloculated pelvic lymphoceles: differences in the treatment of symptomatic pelvic lymphoceles after open radical retropubic prostatectomy. Int Braz J Urol. 2009; 35:164–169. discussion 170.

8. Hamada A, Hwang C, Fleisher J, Tuerk I. Microbiological evaluation of infected pelvic lymphocele after robotic prostatectomy: potential predictors for culture positivity and selection of the best empirical antimicrobial therapy. Int Urol Nephrol. 2017; 49:1183–1191.