Management of postoperative pelvic lymphoceles

Lymphoceles following pelvic surgery are not rare events. The management of this postoperative complication in 18 patients included needle aspiration, external drainage, and intraperitoneal marsupialization. The following diagnostic and therapeutic approach is recommended: ultrasonographic definition of the lymphocele; excretory urography to assess upper urinary tract obstruction; observation of small, nonobstructing, asymptomatic lymphoceles; needle aspiration for diagnosis confirmation; intraperitoneal marsupialization for noninfected, large lymphoceles that are obstructing the upper urinary tract or are symptomatic; and incision and drainage of small or infected lymphoceles.