Lymphadenectomy

A lymphadenectomy is a surgical procedure to remove lymph nodes in the groin. Sometimeslymph nodes in the pelvis may also need to be removed. We explain how these operations are performed and how to prepare for surgery.

Why a Lymphadenectomy?

First, it is helpful to understand more about the lymphatic system and the way lymph nodes work. You can read about the lymph system here.

Penile cancer can spread to the lymph nodes in the groin area. It may then be necessary to remove these nodes using surgery. There are two ways of performing this operation:

Inguinal Lymph Node Dissection

This is a major operation and involves removing the lymph nodes from one or both sides of the groin (the inguinal nodes). This will only be recommended if cancer is suspected or present.

The operation will be performed under an anaesthetic and will typically take two to three hours.

An incision into the groin is made and the lymph nodes are removed.

Modified Lymph Node Dissection

If it is possible that lymph nodes may have been affected by cancer a precautionary approach may be recommended to remove those that might be affected. This is known as a modified lymph node dissection.

This operation is a modified version of the radical one described above. The skin incision is shorter and fewer nodes are removed. If cancer is detected in the removed lymph nodes, then a full dissection (removal of all the lymph nodes in the area) may be recommended.

Pelvic Lymph Node Dissection

If there is evidence that other lymph nodes above those in the groin have been affected by cancer, typically in the pelvic area a further operation may be necessary to remove them.

This operation is similar to an inguinal (groin) lymph node removal. It can either be performed with open surgery or using laparoscopic (keyhole) surgery as shown in the picture.

Recovery from this operation may take slightly longer than groin surgery but in general the post operative care is similar.

After Surgery

After surgery painkillers will be given on a regular basis. It is important that  these are taken regularly and not just when pain is felt.

For the first two to four weeks, men may have a small plastic tube called a wound drain in place. This is to remove excess blood or fluid which can sometimes gather at the operation site. This will allow unwanted substances to drain naturally and healing to take place (see picture below).

Tips 

  • Always ask the  healthcare team exactly what the surgery will involve and what to expect after the operation.
  • Plan ahead and arrange time off work to allow for the healing process.
  • Try to boost health before surgery by eating a healthy diet.
  • If possible, take steady exercise before the operation to stay healthy.
  • Get into the habit of moving feet when at rest and not crossing legs. This will help to prevent blood clots forming  which can sometimes occur when mobility is reduced.

Follow Up

After surgery the tissue that has been removed will be sent to a lab to be analysed by a medical scientist. It usually takes several weeks to get the results. A follow up appointment will usually be made around this time, where the results of these tests and any further treatment is discussed.

Complications

Lymphoedema

This is a condition that may occur following surgery to the groin area. Sometimes surgery may compromise the drainage of the lymph fluid in the pelvic area and this causes lymph fluid to accumulate. This may cause the legs to swell and is called lymphoedema. Lymphoedema can cause pain and discomfort and will need specialist treatment. More information about lymphoedema can be found here

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