RPLND

Sometimes, after chemotherapy, RPLND, or Retroperitoneal Lymph Node Dissection is sometimes needed.

This is performed if cancer may still be present in the abdominal lymph nodes Much of the time this residual tends to be non-cancerous but the only way to know for sure is to have RPLND. It is not usually performed for seminoma unless  lymph nodes are over 3cm in size.

The operation takes up to four hours and is performed under a general anaesthetic. A cut is made from just below the breastbone to just below the navel (belly button).  Lymph nodes on the same side as the affected testicle are removed, followed by any others that look as if they may contain cancer. It will usually require a hospital stay for a week or more.

RPLND can affect fertility. This is because the operation can affect the nerves that control ejaculation (the discharge of sperm through the penis). With new surgical techniques this can usually be avoided.

• Pain killers  should be taken on a regular basis (not just when pain is felt.
• A high fibre diet can help to prevent constipation as this could make pain feel worse. Drinking 2-3 litres of fluid a day can soften stools (poo).  A mild laxative may be recommended.
• Men should take things easy for two weeks after surgery. If living alone, it may be better to stay with someone.
• Avoid heavy lifting and vigorous exercise for at least six weeks to allow abdominal muscles to heal. Walk upright without stooping.
• Do not drive for 3-4 weeks after surgery in case it is difficult to perform an emergncy stop.
• Men should be able to return to work after four weeks but this may need to be longer if you they have a particularly physical job.
• Men will need to obtain a sick certificate from your GP.
• Sexual intercourse should be avoided for approximately four weeks after surgery.

Watch our video that explains why you might need an RPLND procedure and what happens during the operation: