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Treatment outcomes in patients with symptomatic lymphoceles following radical prostatectomy depend upon size and presence of infection

Urology Jul 13, 2020

Andrews JR, Sobol I, Frank I, et al. - Researchers sought to provide guidance for treatment decisions for symptomatic lymphoceles after radical prostatectomy via analyzing their experience and creating a treatment algorithm. From 2003 to 2012, radical prostatectomy was performed on 8,081 patients. Among these, 123 (1.5%) patients developed a symptomatic lymphocele, 70 sterile and 53 infected. Based on their experience, they suggest reserving aspiration of symptomatic lymphoceles for diagnostic purposes because of a high risk of recurrence. Treatment with drain placement and antibiotics is favored for infected lymphoceles, with excellent resolution rates. While successful management of sterile lymphoceles < 10 cm can be done with drain placement, in case, drainage and sclerotherapy fail, they suggest considering laparoscopic unroofing. A shared decision-making process should be undertaken for patients with sterile lymphoceles ≥ 10 cm, to weigh the risk of a protracted course if a drain is used vs upfront laparoscopic unroofing.

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