If there are any signs of potential residual cancer following chemotherapy such as enlarged lymph nodes in the abdomen it may be suggested that men undergo this procedure.It is not usually performed for seminoma unless lymph nodes are over 3cm in size. Hospital stay is usually 7-10 days.
This operation is performed under a general anaesthetic, and can take up to 4 hours to perform. An incision (cut) is made from just below the breastbone to just below the navel (belly button). The intestines and other organs are gently lifted out of the way so that the lymph nodes at the back of the abdomen can be clearly seen. Lymph nodes on the same side as the affected testicle are first removed followed by any others that look suspicious of containing cancerous cells.
Retroperitoneal Lymph node Dissection can affect a man’s fertility, as the operation can damage the nerves that control the discharge of sperm through the penis (ejaculation). New surgical techniques mean that this problem can usually be avoided but the surgeon will be able to advise if there is a possibility that it may happen.If there is a possibility that men may need such surgery, and if they are fit enough to produce sperm samples for storage before treatment starts, some of their sperm can be stored (see Testicular Cancer and Fertility). Although this further surgery may make it more difficult for men to father a child, it should have no physical effect on a man’s ability to get an erection.
- Men will be given painkillers to take home and they should be taken as prescribed on a regular basis (not just when men feel pain)
- Men should try to eat a high fibre diet to prevent constipation which may aggravate any pain that they are already experiencing and should aim to drink 2-3 litres of fluid a day to help soften their stools. A mild laxative may be suggested.
- Take things easy for 2 weeks after surgery.If men live alone it may be beneficial to stay with someone who can keep an eye on them as they may tire easily.
- Heavy lifting and vigorous exercise should be avoided for at least 6 weeks to allow the abdominal muscles to heal. Men should try and walk upright without stooping.
- Men should not drive for 3-4 weeks following surgery as they may not be able to stop effectively in an emergency.
- Men should be able to return to work after 4 weeks but this may need to be longer if they have a particularly physical job.
- Men will need to obtain a sick certificate from their GP.
- Sexual intercourse should be avoided for approximately 4 weeks after surgery.
To read personal stories of men who have been affected and treated for testicular cancer please click here
To download a PDF on RPLND please click here
Last reviewed 27/7/17 Next review January 2018.
References available on request.