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Lymphocele

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User
Posted 23 Nov 2016 at 15:06

Hi, Just had my catheter removed after 21 days post op for RP and the bladder scan showed a lymphocele holding about a litre of fluid. My bladder is

venting all ok, but no control at present..

I am having a CT scan tomorrow to assess this new issue, the urology nurse told me that quite often the fluid is reabsorbed into the body...

Another option that the surgeon might take is to drain the sac....anyone else had experience of this aspect of surgery please?....first time that I

have heard of it....Paul....

User
Posted 24 Nov 2016 at 01:45

Hi Paul,

Back in 2008 I had lymphocele problems.

Basically what happened in my case, was that at diagnosis, after the preliminary scans and TRUS biopsy, they were not sure about one or two of my lymph nodes, so I had a PLND (Pelvic Lymph Node Disection) where they opened me up and took out around a dozen lymph nodes to biopsy, in the event they were clear of cancer, however the PLND was a major operation involving about a week in hospital followed by two more weeks in hospital dealing with post operative infections.

The last of these coincided with difficulty passing urine etc and it turned out lymphoceles were to blame putting pressure on the prostate/urethra/bladder etc.  Also they wanted to do RT and the lymphoceles complicated that.

So I went in to have the lymphoceles drained.  It was a quite straight forward out patient procedure, I lay on my back and they gave me various shots of local anaesthetic in my abdomen.  Then the doctor came in with the biggest hypodermic set up I have ever seen, a glass job, at least a pint capacity with a long needle best part of a foot long.

Using an ultrasound scanner he then inserted the needle, navigated through my innards, and then drew off the lymph fluid, it was all very fascinating, quite painless, and once he had finished I was able to drive home.

In the event it was a waste of time as the fluid came back, and they ended up radiating it when I had RT.

All the detail is written up in my profile, see 2008.

Best of luck.

:)

Dave    

User
Posted 10 Mar 2017 at 22:19

I have just found this post which is 4 months old but for the sake of the records . . .

Four weeks after my op (RARP) I had an uncomfortable lump in my groin, in the next 24 hours my left leg became very swollen. Walking was eye wateringly painful. I was admitted (A&E) and was diagnosed with a lymphocele in my abdomen. After 4 days (Friday to Monday (it was a weekend!!)) I was given the option of draining or nothing. I opted for draining. That afternoon I was told (by a junior doctor) that I should walk (through the pain). I did that and the next morning my leg swelling had reduced. I was discharged . . . see how it goes. Three weeks later the swelling has reduced but my left thigh is still 3cm bigger than my right thigh. I have seen all the 'professionals' involved and they don't seem to know what is going on but want to do nothing hoping (as I do) that whatever is going on will sort itself out.

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User
Posted 24 Nov 2016 at 01:45

Hi Paul,

Back in 2008 I had lymphocele problems.

Basically what happened in my case, was that at diagnosis, after the preliminary scans and TRUS biopsy, they were not sure about one or two of my lymph nodes, so I had a PLND (Pelvic Lymph Node Disection) where they opened me up and took out around a dozen lymph nodes to biopsy, in the event they were clear of cancer, however the PLND was a major operation involving about a week in hospital followed by two more weeks in hospital dealing with post operative infections.

The last of these coincided with difficulty passing urine etc and it turned out lymphoceles were to blame putting pressure on the prostate/urethra/bladder etc.  Also they wanted to do RT and the lymphoceles complicated that.

So I went in to have the lymphoceles drained.  It was a quite straight forward out patient procedure, I lay on my back and they gave me various shots of local anaesthetic in my abdomen.  Then the doctor came in with the biggest hypodermic set up I have ever seen, a glass job, at least a pint capacity with a long needle best part of a foot long.

Using an ultrasound scanner he then inserted the needle, navigated through my innards, and then drew off the lymph fluid, it was all very fascinating, quite painless, and once he had finished I was able to drive home.

In the event it was a waste of time as the fluid came back, and they ended up radiating it when I had RT.

All the detail is written up in my profile, see 2008.

Best of luck.

:)

Dave    

User
Posted 24 Nov 2016 at 07:53

Thanks Dave, this condition isn't that common, good to get first hand experience of what might be in store. The Urology Sister only detected the presence of the lymphocele and estimated its capacity at around a litre....I'm not sure how accurate the bladder scanner is in this type of situation. The CT scan this morning should be more revealing and I assume my surgeon will make a decision on whether to drain or not....

The lymphocele doesn't appear to causing any other problems as far as I am aware unless it is adding to my bowel habit which is still a little difficult to normalise....

 

Paul....

User
Posted 25 Nov 2016 at 16:30
Had the scan and it confirmed that there is a Lymphocele or Collection present, I spoke to my surgeon today and he said that it was quite common post op and as it wasn't causing any issues at present then he was content to leave it alone and see if it reabsorbs......unexpected additional worry for me....this whole thing sort of sucks you in......Paul
User
Posted 26 Nov 2016 at 13:03

Hi Paul,

How I understood it from a sort of engineering perspective is that the lymph system is like the bodies drains, and the lymph nodes are like 'U' bends or waste traps.

That is why in the earliest stages of cancer spreading the rogue cancer cells have a tendency to be caught up in the lymph nodes, imagine your other half lost a ring down the sink, the first place you would look for it is in the 'U' bend.

So when I had the conversation with my consultant, after the PLND, I was expecting trouble, ostensibly the PLND had been to remove one enlarged lymph node next to the prostate, in the event they removed, or in their parlance 'harvested', 12 of them to be on the safe side.

I said to him if I removed 12 'U' bends from my house's plumbing system I would be left with a mess on the floor.  He agreed that is essentially what lymphoceles amount to, the mess left over after the surgeons have disconnected your 'U' bends!

But the body is resilient and in my case, now 8 years after PLND, the mess seems to have been cleared up of its own accord, or at least swept under the carpet.

:)

Dave 

User
Posted 26 Nov 2016 at 14:19

Unfortunately, for some people removing all their U-bends results in lymphodema so for any man that has had nodes removed or significant zapping in the pelvic area it is important to keep an eye out for swollen ankles, calves, etc.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 10 Mar 2017 at 22:19

I have just found this post which is 4 months old but for the sake of the records . . .

Four weeks after my op (RARP) I had an uncomfortable lump in my groin, in the next 24 hours my left leg became very swollen. Walking was eye wateringly painful. I was admitted (A&E) and was diagnosed with a lymphocele in my abdomen. After 4 days (Friday to Monday (it was a weekend!!)) I was given the option of draining or nothing. I opted for draining. That afternoon I was told (by a junior doctor) that I should walk (through the pain). I did that and the next morning my leg swelling had reduced. I was discharged . . . see how it goes. Three weeks later the swelling has reduced but my left thigh is still 3cm bigger than my right thigh. I have seen all the 'professionals' involved and they don't seem to know what is going on but want to do nothing hoping (as I do) that whatever is going on will sort itself out.

User
Posted 11 Mar 2017 at 11:22

Hi Paul,

I am not 100% sure of the body's design etc, I believe the intestines etc are sort of wrapped in an internal cling film bag, the peritoneum, but this can't be totally watertight as various tubes like the urethra have to pass through it.

As Lynn pointed out lymph fluid running south into the legs is not uncommon.

Some years ago I had the opposite problem, a Baker's cyst in my knee, which when it bursts causes the knee to flood the leg with lubricant fluid.  I found that when I lay down the fluid flowed back into my torso.

All I can say of the lymphoceles I had back in 2008, is that they have either gone, or my body has shifted it's components to accommodate them.  I have had subsequent scans, and the doctors have commented on various things they noticed, like cysts on my kidneys, but there has been no mention of lymphoceles.

:)

Dave  

 
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