Retroperitoneal Lymph Node Dissection (RPLND)

Pioneered surgical treatment to revolutionize testicular cancer care

Testicular cancer cells can spread (metastasize) upward into your lymph nodes in the abdomen. When this happens, your treatment team may recommend chemotherapy and/or retroperitoneal lymph node dissection (RPLND) to remove the affected lymph nodes.

RPLND surgery was pioneered at Indiana University in the 1960s. The IU Health urology team, in partnership with the Indiana University School of Medicine, is the world’s leading institution in pioneering the surgical technique.

Testicular cancer has a very predictable pattern of spread in young males from ages 18-45. It exists and grows from germ cells, the cells that make sperm. One primary area where testicular cancer spreads is the lymph nodes in the abdomen. That area, which is at the level of the kidneys, is called the retroperitoneum.

RPLND surgery is a minimally invasive procedure that removes the lymphatic tissues/nodes from around the vena cava and/or aorta. Nerves that control ejaculation course through the retroperitoneum where the lymph nodes are located and may need to be removed. This is dependent upon each individual case. Some nerves can be preserved and separated from the lymphatic tissue.

Performing a nerve-sparing procedure maintains ejaculation after surgery and potential fertility remains intact. This nerve-sparing procedure was pioneered at Indiana University. Outcomes of our nerve-sparing procedures are published and well documented. They have remained excellent over the decades.

Watch: RPLND Surgery for Testicular Cancer

Our History in Revolutionizing Treatment

Testicular cancer retroperitoneal lymph node dissection was first performed in the 1960s to cure patients of metastatic testicular cancer. For over a half century, the IU Health urology team has remained at the forefront of testicular cancer treatment and research.

Who is eligible for RPLND?

RPLND remains an important surgical option for men with testis cancer as a therapeutic treatment option. For patients with clinical stage I or low volume clinical stage II disease, if cancer is found in the retroperitoneal lymph nodes, a properly performed RPLND can be curative in up to 80% of cases. This eliminates the need of chemotherapy and the long-term risk associated with platinum-based chemotherapy..

Patients who have bulkier metastatic disease or elevated AFP or HCG receive chemotherapy and then undergo a CT scan for follow-up imaging.. If residual disease in the retroperitoneum is greater than one centimeter in size, a post-chemotherapy RPLND is recommended to remove teratoma or residual active germ cell tumor elements.

Advantages of RPLND

There are many real advantages to a male patient looking to undergo this treatment at IU Health:

  • Potentially able to avoid chemotherapy
  • Shorter hospital stay and faster recovery
  • Normal ejaculation – the nerves that control ejaculation can be spared in appropriate cases
  • Less complications from surgery

About RPLND Surgery

Testicular cancer has a very predictable pattern of spread in young males from ages 18-45. It exists and grows from germ cells, the cells that make sperm. One primary area where testicular cancer spreads is the lymph nodes in the abdomen. That area, which is at the level of the kidneys, is called the retroperitoneum.

RPLND surgery is a minimally invasive procedure that removes the lymphatic tissues/nodes from around the vena cava and/or aorta. Nerves that control ejaculation course through the retroperitoneum where the lymph nodes are located and may need to be removed. This is dependent upon each individual case. Some nerves can be preserved and separated from the lymphatic tissue.

Performing a nerve-sparing procedure maintains ejaculation after surgery and potential fertility remains intact. This nerve-sparing procedure was pioneered at Indiana University. Outcomes of our nerve-sparing procedures are published and well documented. They have remained excellent over the decades.

Watch: RPLND Surgery for Testicular Cancer

Our History in Revolutionizing Treatment

Testicular cancer retroperitoneal lymph node dissection was first performed in the 1960s to cure patients of metastatic testicular cancer. For over a half century, the IU Health urology team has remained at the forefront of testicular cancer treatment and research.

Who is eligible for RPLND?

RPLND remains an important surgical option for men with testis cancer as a therapeutic treatment option. For patients with clinical stage I or low volume clinical stage II disease, if cancer is found in the retroperitoneal lymph nodes, a properly performed RPLND can be curative in up to 80% of cases. This eliminates the need of chemotherapy and the long-term risk associated with platinum-based chemotherapy..

Patients who have bulkier metastatic disease or elevated AFP or HCG receive chemotherapy and then undergo a CT scan for follow-up imaging.. If residual disease in the retroperitoneum is greater than one centimeter in size, a post-chemotherapy RPLND is recommended to remove teratoma or residual active germ cell tumor elements.

Advantages of RPLND

There are many real advantages to a male patient looking to undergo this treatment at IU Health:

  • Potentially able to avoid chemotherapy
  • Shorter hospital stay and faster recovery
  • Normal ejaculation – the nerves that control ejaculation can be spared in appropriate cases
  • Less complications from surgery

Your IU Health urologic and medical oncologists work together to treat advanced testicular cancer that has spread to other organs of the body.

We partner with social workers and counselors who can help you with emotional aspects of cancer. Your medical team also partners with Indiana University Simon Comprehensive Cancer Center to determine the best plan for you. You will be paired with a testicular cancer nurse navigator to help guide your experience here at IU Health. They will be with you from the start and can answer questions you may have even after you return home after surgery.

We understand that preparing for RPLND surgery can be difficult in young men. We provide men’s sexual and reproductive health experts to guide you through treatment and answer your questions regarding fertility and sexual health concerns.

Preparing for Surgery

Your IU Health urologic and medical oncologists work together to treat advanced testicular cancer that has spread to other organs of the body.

We partner with social workers and counselors who can help you with emotional aspects of cancer. Your medical team also partners with Indiana University Simon Comprehensive Cancer Center to determine the best plan for you. You will be paired with a testicular cancer nurse navigator to help guide your experience here at IU Health. They will be with you from the start and can answer questions you may have even after you return home after surgery.

We understand that preparing for RPLND surgery can be difficult in young men. We provide men’s sexual and reproductive health experts to guide you through treatment and answer your questions regarding fertility and sexual health concerns.

Medical advances have made the overall cure for testicular cancer about 95 percent. RPLND surgical treatment has become so effective that males commonly do not have recurrence.

However, surveillance is crucial. Your medical team will recommend you perform self-exams and return for regular check-ups. If traveling from locations outside of Indiana, your physicians can communicate future surveillance schedules or find local providers to keep in touch with you.

After Your Surgery

Medical advances have made the overall cure for testicular cancer about 95 percent. RPLND surgical treatment has become so effective that males commonly do not have recurrence.

However, surveillance is crucial. Your medical team will recommend you perform self-exams and return for regular check-ups. If traveling from locations outside of Indiana, your physicians can communicate future surveillance schedules or find local providers to keep in touch with you.

The surgical experience for RPLND is the most robust in the nation and this translates into higher quality care and lower risk of any complication. You will be receiving the highest level of care in the country at IU Health.

Our passion for caring for men with testicular cancer is displayed in our decades of research driving the field forward whether through surgical innovations or chemotherapy improvements. We remain deeply committed to advancing care for testicular through research, education and clinical experience.

You will have a common contact with our testicular cancer nurse navigator to ensure seamless care with us at IU Health whether you are traveling from across the country or just down the street.

We provide a packet after surgery with easy to follow and understand instructions regarding diet, nutrition and exercise regimes to help ensure a full quick recovery.

Why IU Health for RPLND Surgery

The surgical experience for RPLND is the most robust in the nation and this translates into higher quality care and lower risk of any complication. You will be receiving the highest level of care in the country at IU Health.

Our passion for caring for men with testicular cancer is displayed in our decades of research driving the field forward whether through surgical innovations or chemotherapy improvements. We remain deeply committed to advancing care for testicular through research, education and clinical experience.

You will have a common contact with our testicular cancer nurse navigator to ensure seamless care with us at IU Health whether you are traveling from across the country or just down the street.

We provide a packet after surgery with easy to follow and understand instructions regarding diet, nutrition and exercise regimes to help ensure a full quick recovery.

RPLND Research & Clinical Trials

IU Health, in partnership with IU School of Medicine continues to build upon the work physicians have done over the past 50 years. Researchers are currently studying ways to improve pain after surgery as well as how to shorten the length of the hospital stay. To do this, they are looking at newer pain regimens and medications to maintain normal bowel function. This is the largest study ever conducted in this patient population.

The research team is also doing a mapping trial for stage II seminoma patents. The goal is to understand if the nodal drainage pattern of seminoma is similar to nonseminoma. Predictive markers for recurrence are also being explored in this trial. In addition, researchers and physicians are thoroughly studying specific patient types among those diagnosed with testis cancer.

View examples of our research below:

Mar 26

UIndy lacrosse player thought his pain was from the game

Colorado resident Joe (Joey) Bertrand is thankful to be in Indiana where he is receiving the best care for testicular cancer.

UIndy lacrosse player thought his pain was from the game image.

Patient Stories for Retroperitoneal Lymph Node Dissection (RPLND)

Mar 26

UIndy lacrosse player thought his pain was from the game

Colorado resident Joe (Joey) Bertrand is thankful to be in Indiana where he is receiving the best care for testicular cancer.

UIndy lacrosse player thought his pain was from the game image.