Introduction: We aimed at evaluating the incidence of lymphoceles, a common complication after radical retropubic prostatectomy (RRP), at a high volume centre, define risk factors and assess the clinical outcome. Materials and Methods: 454 patients receiving RRP and pelvic lymph node dissection were assessed for postoperative lymphoceles using the ultrasound method. Findings were correlated to clinical parameters from a database (age, BMI, initial PSA, number of lymph nodes removed, prostate weight, duration of surgery, hospital stay, duration of catheterisation) and possible unconventional risk factors using meteorological data. Results: Overall, 15.4% developed a lymphocele, 2.6% had a symptomatic lymphocele requiring treatment. The mean size of the lymphoceles requiring treatment was significantly higher (400 vs. 115 ml). Patients with lymphocele stayed longer in hospital. No correlation could be found between the clinical parameters and the risk for lymphoceles. Functional results in terms of urinary continence were similar. The assessment of meteorological risk factors showed a correlation of lymphoceles with air humidity. Conclusion: Lymphoceles are common after RRP, but few cases require intervention. There is no reliable clinical predictor for the risk of lymphocele development. Data sets have been published suggesting several risk factors but may be subject to statistical error like in the case of the meteorological predictors in this study.

1.
Heidenreich A, Bastian PJ, Bellmunt J, et al: EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol 2014;65:124-137.
2.
Anheuser P, Treiyer A, Stark E, Haben B, Steffens JA: [Lymphoceles after radical retropubic prostatectomy. A treatment algorithm]. Urologe A 2010;49:832-836.
3.
Froehner M, Novotny V, Koch R, Leike S, Twelker L, Wirth MP: Perioperative complications after radical prostatectomy: open versus robot-assisted laparoscopic approach. Urol Int 2013;90:312-315.
4.
Novara G, Ficarra V, Rosen RC, et al: Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol 2012;62:431-452.
5.
Solberg A, Angelsen A, Bergan U, Haugen OA, Viset T, Klepp O: Frequency of lymphoceles after open and laparoscopic pelvic lymph node dissection in patients with prostate cancer. Scand J Urol Nephrol 2003;37:218-221.
6.
Beyer J, Wessela S, Hakenberg OW, et al: Incidence, risk profile and morphological pattern of venous thromboembolism after prostate cancer surgery. J Thromb Haemost 2009;7:597-604.
7.
Wagner M, Sokoloff M, Daneshmand S: The role of pelvic lymphadenectomy for prostate cancer - therapeutic? J Urol 2008;179:408-413.
8.
Simonato A, Varca V, Esposito M, Venzano F, Carmignani G: The use of a surgical patch in the prevention of lymphoceles after extraperitoneal pelvic lymphadenectomy for prostate cancer: a randomized prospective pilot study. J Urol 2009;182:2285-2290.
9.
Rousseau B, Doucet L, Perrouin Verbe MA, et al: [Comparison of the morbidity between limited and extended pelvic lymphadenectomy during laparoscopic radical prostatectomy]. Prog Urol 2014;24:114-120.
10.
Kim JK, Jeong YY, Kim YH, Kim YC, Kang HK, Choi HS: Postoperative pelvic lymphocele: treatment with simple percutaneous catheter drainage. Radiology 1999;212:390-394.
11.
Hsu TH, Gill IS, Grune MT, et al: Laparoscopic lymphocelectomy: a multi-institutional analysis. J Urol 2000;163:1096-1098; discussion 1098-1099.
12.
Silas AM, Forauer AR, Perrich KD, Gemery JM: Sclerosis of postoperative lymphoceles: avoidance of prolonged catheter drainage with use of a fibrin sealant. J Vasc Interv Radiol 2006;17:1791-1795.
13.
Teruel JL, Escobar EM, Quereda C, Mayayo T, Ortuño J: A simple and safe method for management of lymphocele after renal transplantation. J Urol 1983;130:1058-1059.
14.
Varga Z, Hegele A, Olbert P, Hofmann R, Schrader AJ: Laparoscopic peritoneal drainage of symptomatic lymphoceles after pelvic lymph node dissection using methylene blue instillation. Urol Int 2006;76:335-338.
15.
Danuser H, Di Pierro GB, Stucki P, Mattei A: Extended pelvic lymphadenectomy and various radical prostatectomy techniques: is pelvic drainage necessary? BJU Int 2013;111:963-969.
16.
Orvieto MA, Coelho RF, Chauhan S, Palmer KJ, Rocco B, Patel VR: Incidence of lymphoceles after robot-assisted pelvic lymph node dissection. BJU Int 2011;108:1185-1190.
17.
Briganti A, Chun FK, Salonia A, et al: Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer. Eur Urol 2006;50:1006-1013.
18.
Campbell SC, Klein EA, Levin HS, Piedmonte MR: Open pelvic lymph node dissection for prostate cancer: a reassessment. Urology 1995;46:352-355.
19.
Heidenreich A, Varga Z, Von Knobloch R: Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 2002;167:1681-1686.
20.
Mundhenk J, Hennenlotter J, Alloussi S, et al: Influence of body mass index, surgical approach and lymphadenectomy on the development of symptomatic lymphoceles after radical prostatectomy. Urol Int 2013;90:270-276.
21.
Musch M, Klevecka V, Roggenbuck U, Kroepfl D: Complications of pelvic lymphadenectomy in 1,380 patients undergoing radical retropubic prostatectomy between 1993 and 2006. J Urol 2008;179:923-928; discussion 928-929.
22.
Pepper RJ, Pati J, Kaisary AV: The incidence and treatment of lymphoceles after radical retropubic prostatectomy. BJU Int 2005;95:772-775.
23.
Rassweiler J, Seemann O, Schulze M, Teber D, Hatzinger M, Frede T: Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. J Urol 2003;169:1689-1693.
24.
Capitanio U, Pellucchi F, Gallina A, et al: How can we predict lymphorrhoea and clinically significant lymphocoeles after radical prostatectomy and pelvic lymphadenectomy? Clinical implications. BJU Int 2011;107:1095-1101.
25.
Naselli A, Andreatta R, Introini C, Fontana V, Puppo P: Predictors of symptomatic lymphocele after lymph node excision and radical prostatectomy. Urology 2010;75:630-635.
26.
Gotto GT, Yunis LH, Guillonneau B, et al: Predictors of symptomatic lymphocele after radical prostatectomy and bilateral pelvic lymph node dissection. Int J Urol 2011;18:291-296.
27.
Khoder WY, Trottmann M, Buchner A, et al: Risk factors for pelvic lymphoceles post-radical prostatectomy. Int J Urol 2011;18:638-643.
28.
Kröpfl D, Krause R, Hartung R, Pfeiffer R, Behrendt H: Subcutaneous heparin injection in the upper arm as a method of avoiding lymphoceles after lymphadenectomies in the lower part of the body. Urol Int 1987;42:416-423.
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