Lymphocele After Radical Prostatectomy: A Systematic Review of Risk Factors and Quantitative Synthesis Preventive Strategies

This study aimed to systematically evaluate the perioperative risk factors and preventive strategies associated with lymphocele formation and prolonged lymphatic drainage after radical prostatectomy with pelvic lymph node dissection, to assess the effect of peritoneal reconstruction techniques on symptomatic lymphocele reduction, and to provide an integrated clinical framework for evaluating etiological factors and preventive strategies.

A comprehensive search of Embase, MEDLINE (PubMed), and the Cochrane Library was performed through December 2025 according to PRISMA guidelines (PROSPERO ID: CRD420251164157). Thirty-one studies evaluating preoperative, intraoperative, and postoperative risk factors and preventive strategies were included. Risk of bias was assessed using RoB 2, ROBINS-I, and ROBINS-E tools. A primary meta-analysis of randomized controlled trials and a predefined sensitivity analysis including all comparative studies were conducted for symptomatic lymphocele (sLC) using random-effects models.