Obstructive Uropathy From a Pelvic Lymphocele After Robotic-Assisted Radical Prostatectomy and Pelvic Lymph Node Dissection: A Case Report

机器人辅助根治性前列腺切除术和盆腔淋巴结清扫术后盆腔淋巴囊肿引起的梗阻性尿路疾病:病例报告

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Abstract

Lymphocele formation after pelvic lymph node dissection (PLND) in radical prostatectomy (RP) is a well-recognized but often underestimated complication. Although most lymphoceles remain asymptomatic, those that become symptomatic can be troublesome and even life-threatening if venous thromboembolism occurs. We present the case of a 68-year-old man with prostate cancer who underwent an uneventful robotic-assisted RP (RaRP) with bilateral PLND. One month later, he presented with right flank pain, leukocytosis, and acute kidney injury. Imaging revealed large lymphoceles causing right hydronephrosis. A right ureteral stent was placed, immediately relieving symptoms and restoring renal function. At three-month follow-up, a computed tomography (CT) scan demonstrated partial regression of the lymphoceles, and the patient remained symptom-free after stent removal. This case demonstrates alternative management for lymphocele-related complications when it comes to obstructive uropathy using an internal stent to relieve the patient's symptoms, an option that has not been previously documented in the literature.

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