✦ Prostate Cancer Treatment

Pelvic Lymph Node Dissection (PLND)

Q: Does PLND improve survival?

Yes — extended PLND removes micrometastatic disease and has therapeutic benefit in patients with limited lymph node involvement. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: What are the risks of PLND?

Main risks include lymphocele (fluid collection), lymphoedema of the leg, and vascular injury; these are uncommon with careful technique.

Q: How many lymph nodes should be removed?

Extended PLND should remove at least 20 lymph nodes; greater node counts improve staging accuracy and therapeutic benefit. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Surgical Removal of Pelvic Lymph Nodes for Staging and Cure in Prostate Cancer

60–90 min PROCEDURE

1–2 Days HOSPITAL STAY

>90% staging SUCCESS RATE

2–3 Weeks RECOVERY

What is Pelvic Lymph Node Dissection (PLND)?

Pelvic Lymph Node Dissection (PLND) is a surgical procedure performed at the time of radical prostatectomy or independently to remove the regional lymph nodes draining the prostate. It is the most accurate method for lymph node staging in prostate cancer. Extended PLND (ePLND) removes nodes from the external iliac, obturator, and internal iliac regions and can also be therapeutic — removing micrometastatic disease and improving survival in node-positive patients. The procedure is performed under general or spinal anaesthesia with a hospital stay of 1–2 Days.

Men with intermediate or high-risk localised prostate cancer undergoing radical prostatectomy, or those requiring lymph node staging for treatment planning. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Access & Peritoneal Incision

PLND is performed through the same incision or ports used for the radical prostatectomy.

Obturator Packet Dissection

The obturator packet — nodal tissue between the external iliac vein and pelvic sidewall — is removed.

External Iliac Dissection

Nodal tissue along the anterior and lateral surfaces of the external iliac artery and vein is dissected and removed.

Internal Iliac Dissection

For extended PLND, the internal iliac nodal packet is removed between the internal iliac artery and the pelvic sidewall.

Haemostasis & Closure

All lymphatic vessels are clipped or tied after node packet removal. Haemostasis is confirmed from the nodal bed before closure.

Outcomes

60–90 minDURATION

1–2 DaysHOSPITAL STAY

>90% stagingSUCCESS RATE

2–3 WeeksFULL RECOVERY

Who Needs This Treatment?

→Men undergoing radical prostatectomy for intermediate or high-risk localised prostate cancer.
→Those with PSA over 10 ng/mL, Gleason score 7+, or clinical stage T2b or higher.
→Patients with high-risk features (Gleason 8–10, PSA >20, T3) where nodal staging is essential.
→Those undergoing radical cystectomy for bladder cancer or nephroureterectomy for upper tract TCC.
→Men where pathological N-staging determines eligibility for clinical trials or adjuvant therapy.
→Patients whose surgeons perform extended rather than standard PLND for maximum staging accuracy.

"Extended pelvic lymph node dissection is not just a staging procedure — it is therapeutic. Removing micrometastatic nodal disease gives our patients the best chance of long-term cure."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Does PLND improve survival?+

What are the risks of PLND?+

How many lymph nodes should be removed?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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