Lymph node surgery – RPLND

Will I be able to have children after RPLND?

If your cancer has spread to your lymph nodes you will probably have chemotherapy to shrink them. If they don’t go back to normal size, the only way to know for sure why not is to take them out and send them to be looked at under a microscope. The operation to remove these lymph nodes is called a retro peritoneal lymph node dissection or RPLND.

Reasons for swollen lymph nodes

A collection of dead cells in the glands, known as necrotic tissue.
Cells in the nodes that may turn cancerous in the future
Cancer cells that remain in the nodes

How is RPLND surgery done?

You will need to have a general anaesthetic for this operation. It is a long operation, usually lasting a number of hours. It involves a cut from the top of your tummy (abdomen) down to below your belly button to allow the surgeon to remove the lymph nodes that are behind your organs. These nodes lie between your kidneys and the blood vessels that carry blood to and from the heart.

All operations have a risk of complications such as bleeding and infection. In RPLND there is a risk of needing to have your kidney removed or you may need a graft to the blood vessels to or from your heart. Before your operation, your doctor will discuss these possible complications with you.

Your wound

The wound will be along your tummy. The line of stitches will go from below your breastbone to your pubic bone. Stitches or staples are usually removed 7 to 10 days after your surgery.

Will I be able to have children after RPLND?

After RPLND some men have a ‘dry’ ejaculation. This means no semen comes out when you climax. If you have a dry ejaculation you are less likely to be able to father a child naturally.

If you want to start a family or have more children, ask your doctor about ways that your sperm can be collected.