Obstructive Uropathy From a Pelvic Lymphocele After Robotic-Assisted Radical Prostatectomy and Pelvic Lymph Node Dissection: A Case Report.

Lymphocele formation after pelvic lymph node dissection (PLND) in radical prostatectomy (RP) is a well-recognized but often underestimated complication. Although most lymphoceles remain asymptomatic, those that become symptomatic can be troublesome and even life-threatening if venous thromboembolism occurs. We present the case of a 68-year-old man with prostate cancer who underwent an uneventful robotic-assisted RP (RaRP) with bilateral PLND. One month later, he presented with right flank pain, leukocytosis, and acute kidney injury. Imaging revealed large lymphoceles causing right hydronephrosis. A right ureteral stent was placed, immediately relieving symptoms and restoring renal function. At three-month follow-up, a computed tomography (CT) scan demonstrated partial regression of the lymphoceles, and the patient remained symptom-free after stent removal. This case demonstrates alternative management for lymphocele-related complications when it comes to obstructive uropathy using an internal stent to relieve the patient's symptoms, an option that has not been previously documented in the literature.