Two cases of pelvic lymphocele after prostatectomy and dissection of obturator lymph nodes successfully treated by interventional radiology

Abstract

Introduction Postoperative refractory lymphocele is often difficult to treat. Recently, interventional radiology with N‐butyl‐cyanoacrylate has been used by urologists and radiologists to treat lymphocele. This modality is an effective treatment with fewer complications. Case presentation Case 1. A 70‐year‐old man, who underwent retropubic radical prostatectomy and bilateral obturator lymph node dissection, developed postoperative lymphocele. Continuous drainage and multiple rounds of sclerotherapy to reduce lymphocele volume ended in failure. Subsequently, lymphangiography with lipiodol and N‐butyl‐cyanoacrylate was performed, and the lymphocele volume gradually decreased. Case 2. A 75‐year‐old man underwent retropubic radical prostatectomy and bilateral obturator lymph node dissection. After surgery, the patient developed a high‐output lymphocele. The lymphocele volume decreased following lymphangiography with lipiodol. Conclusion Interventional radiology using lipiodol and N‐butyl‐cyanoacrylate could provide a new standard treatment for refractory lymphocele.

Keywords

• lymphangiography
• N‐butyl‐cyanoacrylate
• Refractory lymphocele