Prostatic Lymphography

Direct intraprostatic injection of ethiodol was done in 12 patients with benign prostatic hypertrophy to visualize lymphatic drainage of the prostate gland. In all 12 patients lymphatics of the prostate could be visualized well. The findings of our study indicate that the prostate mainly drains through 3 sets of lymphatics: 1) the main and important set of lymphatics starts from the superolateral angle of the prostate and courses along the lateral pelvic wall to drain into the internal iliac lymph nodes, 2) some lymphatics drain into the lymph nodes in the presacral area and 3) in 45% of the patients lymphatics from the apex of the prostate travel along the course of the internal pudendal vessels to the internal iliac lymph nodes. From the internal iliac lymph nodes the drainage is to the common iliac lymph nodes and, finally, to the lumbar lymph nodes. Each lateral lobe of the prostate drains mainly into the ipsilateral group of lymph nodes with little crossover of lymphatics to the opposite side. All patients tolerated the procedure well and there were no complication during or after the procedure. We believe that this procedure is a safe, simple and direct method to visualize lymphatic drainage of the human prostate gland.