Inguinal lymphadenectomy

The indication for such surgery in urology exists in the following cases

• pT1, pT2 or pT3 stage penile cancer. In selected cases of cN0 patients, i.e. without clinically relevant lymph nodes, the sentilla lymph node approach may be indicated;
• Penile cancer with clinically relevant lymphadnopathies (stage cN1, cN2 and cN3).

Although inguinal lymph node invasion is considered an inauspicious factor, lymphadenectomy can be curative and give a five-year probability of cancer-specific survival in up to 70% of cases.

Finally, inguinal lymphadenectomy can also be a palliative intervention in patients with distant metastases. In fact, if metastatic inguinal lymph nodes are not removed, they can easily become infected, causing abscesses and inguinal ulcers.

Inguinal lymphadenectomy is a delicate procedure, and due to the close relationship of the inguinal lymph nodes to the skin, it may require surgical reconstruction using skin grafts. Inguinal lymphadenctomy can be performed by open, laparoscopic, or robotic technique. It consists in the removal of all superficial and deep inguinal lymph nodes, located in the vicinity of femoral vessels. A drainage tube is left in place. It is often associated with parietal/total glandulectomy/penectomy surgery.