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Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma
A clinically significant obturator nerve injury is uncommon after robot-assisted radical prostatectomy and lymphadenectomy. If the injury is due to a direct intraoperative event such as transection or stretching of the nerve, the patients present typically in the immediate postoperative period. On t...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057161/ https://www.ncbi.nlm.nih.gov/pubmed/30090750 http://dx.doi.org/10.4103/ajm.AJM_215_17 |
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author | Aljomaa, Ayman |
author_facet | Aljomaa, Ayman |
author_sort | Aljomaa, Ayman |
collection | PubMed |
description | A clinically significant obturator nerve injury is uncommon after robot-assisted radical prostatectomy and lymphadenectomy. If the injury is due to a direct intraoperative event such as transection or stretching of the nerve, the patients present typically in the immediate postoperative period. On the other hand, an indirect injury through compression of the nerve through a pelvic fluid collection (hematoma or lymphocele) progresses insidiously and delays the presentation of these patients making a dilemma in recognizing these patients and differentiating them from those with other causes of neurological deficits. A delay in the correct management of the compressing collections may negatively affect the neurological function of the patient. We demonstrate a 61-year-old male who presented with pain and motor weakness of obturator origin 1 week after robot-assisted radical prostatectomy and lymphadenectomy for prostatic cancer. The computed tomography scan showed bilateral pelvic lymphoceles possibly compressing the obturator nerves. The neurological function has improved after evacuation of these collections. This case emphasizes the importance of considering delayed postsurgical compression of the obturator nerve in our differential diagnosis when patients present with typical signs and symptoms of obturator nerve injury after robot-assisted radical prostatectomy and lymphadenectomy. Early diagnosis and evacuation of these collections would improve the neurological outcome. |
format | Online Article Text |
id | pubmed-6057161 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-60571612018-08-08 Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma Aljomaa, Ayman Avicenna J Med Case Report A clinically significant obturator nerve injury is uncommon after robot-assisted radical prostatectomy and lymphadenectomy. If the injury is due to a direct intraoperative event such as transection or stretching of the nerve, the patients present typically in the immediate postoperative period. On the other hand, an indirect injury through compression of the nerve through a pelvic fluid collection (hematoma or lymphocele) progresses insidiously and delays the presentation of these patients making a dilemma in recognizing these patients and differentiating them from those with other causes of neurological deficits. A delay in the correct management of the compressing collections may negatively affect the neurological function of the patient. We demonstrate a 61-year-old male who presented with pain and motor weakness of obturator origin 1 week after robot-assisted radical prostatectomy and lymphadenectomy for prostatic cancer. The computed tomography scan showed bilateral pelvic lymphoceles possibly compressing the obturator nerves. The neurological function has improved after evacuation of these collections. This case emphasizes the importance of considering delayed postsurgical compression of the obturator nerve in our differential diagnosis when patients present with typical signs and symptoms of obturator nerve injury after robot-assisted radical prostatectomy and lymphadenectomy. Early diagnosis and evacuation of these collections would improve the neurological outcome. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6057161/ /pubmed/30090750 http://dx.doi.org/10.4103/ajm.AJM_215_17 Text en Copyright: © 2018 Avicenna Journal of Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Aljomaa, Ayman Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma |
title | Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma |
title_full | Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma |
title_fullStr | Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma |
title_full_unstemmed | Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma |
title_short | Delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma |
title_sort | delayed bilateral obturator nerve injury due to compressing bilateral pelvic lymphoceles after robot-assisted laparoscopic radical prostatectomy and bilateral lymphadenectomy for prostatic carcinoma |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057161/ https://www.ncbi.nlm.nih.gov/pubmed/30090750 http://dx.doi.org/10.4103/ajm.AJM_215_17 |
work_keys_str_mv | AT aljomaaayman delayedbilateralobturatornerveinjuryduetocompressingbilateralpelviclymphocelesafterrobotassistedlaparoscopicradicalprostatectomyandbilaterallymphadenectomyforprostaticcarcinoma |