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U.S. News and World Report: America's Best Hospitals, Urology, 2012-13

 

Retroperitoneal Lymph Node Dissection (RPLND)

Related Conditions

Genitourinary Cancer

Retroperitoneal Lymph Node Dissection (RPLND) is performed by surgeons at the University of Wisconsin Carbone Cancer Center, the state's only comprehensive cancer center.
 
Retroperitoneal Lymph Node Dissection (RPLND)
 
Testicular cancer usually spreads via a very predictable route through the lymph nodes called the retroperitoneal lymph nodes. They are located behind the major organs in the belly along the vena cava and aorta. In certain cancer situations it makes sense to remove these nodes. In other situations the RPLND is not recommended.
 
The RPLND involves an incision from just below your sternum to just below the belly button. Your intestines and associated organs are retracted and the surgeon removes all the lymph nodes that were connected to the testicle containing the tumor. The operation typically takes three to six hours.
 
The lymph nodes on the same side as the affected testicle are analyzed first, and if cancer is found or if the case is high risk for spread additional lymph nodes of the other side of the abdomen are removed. Typically hospitalization is for three to five days. Individuals are encouraged to consider fertility preservation such as sperm banking prior to surgery or chemotherapy.
 
Potential risks include:
  • Prolonged bowel inactivity (also called "ileus")
  • Bowel obstruction
  • Infertility due to retrograde ejaculation. In some situations you will lose the ability to ejaculate normally. You'll still ejaculate, but your sperm will end up in the bladder. This complication can typically be avoided in lower stage disease.
  • Infection
  • Damage to surrounding organs. This typically is only a risk in post-chemotherapy removal of masses.
  • Lymphocele: lymphatic fluid continues to collect in the abdomen.