WHAT IS PELVIC LYMPH NODE DISSECTION (PLND)?

Pelvic lymph node dissection (PLND) is a surgical procedure performed during radical cystectomy to remove lymph nodes surrounding the bladder. The primary goals are to determine whether bladder cancer has spread to the lymphatic system, provide accurate pathological staging, and potentially improve oncological outcomes in appropriately selected patients. According to the 2026 European Association of Urology (EAU) Guidelines, bilateral pelvic lymph node dissection is an essential component of standard radical cystectomy for Muscle-Invasive Bladder Cancer (MIBC).

TABLE OF CONTENTS

What is pelvic lymph node dissection?

Why are lymph nodes removed?

Who requires PLND?

What happens during the operation?

What are the benefits of PLND?

Are there any risks?

The EAU 2026 key message for patients

Robotic pelvic lymph node dissection with Assoc. Prof. Dr. Serdar Yalçın

Frequently Asked Questions

WHAT IS PELVIC LYMPH NODE DISSECTION?

Pelvic lymph node dissection is the surgical removal of lymph nodes located within the pelvis during radical cystectomy.

The procedure provides accurate pathological staging and may also remove microscopic lymph node metastases that cannot be detected by current imaging techniques.

WHY ARE LYMPH NODES REMOVED?

The pelvic lymph nodes are among the first locations where bladder cancer may spread.

Removing these lymph nodes helps to:

• Determine the true stage of the disease

• Improve pathological assessment

• Guide postoperative treatment decisions

• Potentially improve long-term oncological outcomes in selected patients

WHO REQUIRES PLND?

According to the 2026 European Association of Urology (EAU) Guidelines, pelvic lymph node dissection should be performed in:

• Patients undergoing radical cystectomy for Muscle-Invasive Bladder Cancer (MIBC)

• Selected patients with very high-risk bladder cancer when radical cystectomy is indicated

PLND is considered an essential part of standard surgical management.

WHAT HAPPENS DURING THE OPERATION?

During radical cystectomy, lymph nodes on both sides of the pelvis are carefully removed within standardized anatomical boundaries.

The removed lymph nodes are then examined by specialized pathologists to determine whether cancer cells are present.

WHAT ARE THE BENEFITS OF PLND?

Potential benefits include:

• More accurate pathological staging

• Better postoperative treatment planning

• Removal of microscopic lymph node metastases

• Improved long-term cancer outcomes in selected patients

ARE THERE ANY RISKS?

As with any surgical procedure, potential complications include:

• Bleeding

• Lymphatic leakage

• Lymphocele formation

• Rare injury to nearby blood vessels or nerves

When performed by experienced surgical teams, the overall risk of serious complications remains low.

THE EAU 2026 KEY MESSAGE FOR PATIENTS

According to the 2026 European Association of Urology (EAU) Guidelines, bilateral pelvic lymph node dissection within appropriate anatomical templates should be performed during radical cystectomy whenever indicated.

Treatment in experienced, high-volume centers contributes to optimal surgical quality and patient outcomes.

ROBOTIC PELVIC LYMPH NODE DISSECTION WITH ASSOC. PROF. DR. SERDAR YALÇIN

Assoc. Prof. Dr. Serdar Yalçın performs robotic radical cystectomy with pelvic lymph node dissection in Bodrum, Türkiye, following current international surgical standards and the latest European Association of Urology (EAU) Guidelines.

The surgical approach is individualized according to tumor stage, imaging findings, anatomical considerations, and each patient’s overall health.

In addition to patients from Bodrum and the Muğla region, individuals from across Türkiye and abroad seek consultation for robotic bladder cancer surgery, second opinions, and advanced uro-oncological treatment planning.

Patients frequently emphasize detailed communication, evidence-based surgical planning, individualized care, and close postoperative follow-up throughout their treatment journey.

CONCLUSION

Pelvic lymph node dissection is an integral component of radical cystectomy for Muscle-Invasive Bladder Cancer. Accurate staging, individualized postoperative treatment planning, and the potential removal of microscopic metastatic disease contribute to improved long-term oncological outcomes.

FREQUENTLY ASKED QUESTIONS

Does removing lymph nodes mean the cancer has already spread?

No. Lymph nodes are removed both for accurate staging and to treat possible microscopic metastatic disease.

Does every patient undergoing radical cystectomy need pelvic lymph node dissection?

In most patients with Muscle-Invasive Bladder Cancer, yes. Current international guidelines recommend bilateral pelvic lymph node dissection as part of standard surgical treatment.

Can radical cystectomy be performed without removing lymph nodes?

Except in rare, carefully selected situations, current international guidelines recommend pelvic lymph node dissection as an essential component of radical cystectomy.

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