Turkish Journal of Urology
Original Article

Management of obturator nevre injury during pelvic lymph node dissection


Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey


Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey


Department of Urology, Ankara University School of Medicine, Ankara, Turkey

Turk J Urol 1; 1: 0-0
DOI: 10.5152/tud.2018.26235
Read: 103 Downloads: 11 Published: 25 July 2019


Objective: Obturator nerve injuries may be seen during pelvic lymph node dissection in oncological surgery and although not common it is an important complication. According to the shape and location of the injury, tingling and loss of sensation may develop on the inner surface of the leg, together with loss of motor function of the adductor muscles. In this study an evaluation was made of these complications encountered in our clinic and the management strategies applied to these patients.


Material and methods: The data were retrospectively reviewed of 843 patients who underwent open radical retropubic prostatectomy between January 2002 and May 2016. To confirm obturator nerve palsy, electrophysiological investigation (ENG-EMG) was performed immediately postoperatively and 3 weeks later.


Results: A total of 6 obturator nerve injuries occurred during pelvic lymphadenectomy (0.7%). Reapproximation end to end with sutures was applied in 3 case and sural nerve graft in 1. In the other 2 patients, just clips were placed and these were removed early during the operation. After the treatment period, neurotropic medications or physiotherapy were given in some cases according to the neurological examinations.


Conclusion: Obturator nerve injury can be prevented by having a comprehensive knowledge of pelvic anatomy, and avoiding the use of electrocautery during lymph node dissection. The repair should be performed as soon as possible, with a tension-free reapproximation of the ends, using electrophysiological tests with a multidisciplinary approach and benefit should be taken from physiotherapy and medical treatment when needed.



Cite this article as: Yıkılmaz TN, Öztürk E, Hamidi N, Başar H, Yaman Ö. Management of obturator nevre injury during pelvic lymph node dissection. Turk J Urol 2017; 44: DOI: 10.5152/tud.2018.26235

ISSN2149-3235 EISSN 2149-3057