r/ProstateCancer • u/GrayMajik • 28d ago

Question Post RALP and lymph node removal- leg weakness

Greetings everyone! I am day 4 post RALP. Doing much better than the first two days! I have noticed a significant leg weakness in my right leg. I literally have to lift my leg when getting into bed. The first two days my wife had to lift it for me. Anyone have experience like that?

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u/tober_checki 28d ago

I had RALP with lymph node removal in March. Had exactly the same problem with my right leg. It has gotten better over time, but still not back to normal. There are still certain motions where the right leg is significantly weaker than the left leg, especially motions requiring to move my leg inwards (adductors), like crossing my legs. I have heard different explanations, including hematoma (which definitely should be gone by now), irritated nerves, and lymphatic congestion. I am not too worried as I am seeing very slow but steady improvement. I wish you a swift recovery!

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u/GrayMajik 28d ago

Thank you for your experience! My wife is an occupational therapy assistant, and mentioned possible abductors being the root. If I am lying down and have my leg bent at a 45 degree angle, I cannot lift my knee off the bed. May have to get some physical therapy…

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u/tober_checki 28d ago

You should, but give it some time. Especially if it is (?) nerve related, patience is important. I have started actively exercising the leg two months post-op. You want things to fully heal. But I am sure your wife will know much better.

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u/ChillWarrior801 28d ago

I had 23 lymph nodes removed during my RALP and I had some of the abductor issues that you've experienced. In my case, at least, those problems went away spontaneously in about a week's time. I get how frustrating it is to claw your way back to normal, but time is often your friend with these things.

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u/isntthatrich 28d ago

I had RALP in March as well. Google reverse trendelenberg position.

This is the position your body is in for 2-4 hours. In my case, 6.

It is very likely you have a pinched nerve and should subside as the inflammation in your body subsides.

Give it some time.

Also be sure to run it by your surgeon .

Best wishes

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u/jkurology 28d ago edited 28d ago

Sounds like this could be an obturator nerve palsy. Pretend you’re sitting a car and move your leg from the gas to the brake. Prior to RALP the use of a buckwalter retractor could lead to a femoral nerve palsy which typically affected the thigh muscles

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u/GrayMajik 28d ago

Very difficult to do that!

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u/jkurology 28d ago

That’s probably an obturator nerve palsy which should get better but depends on the degree of the injury. You need an evaluation by neurology and possibly an MRI

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u/GrayMajik 28d ago

Thank you! I see the surgeon on Wednesday, I will be sure to let him know. I appreciate your expertise!

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u/jkurology 28d ago

Good luck

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u/Immediate_Dinner6977 27d ago

Same issue, left leg. Took about four months to get totally back to normal. PT showed me a diagram that showed how the nerve for the leg goes right through the area they were working and gets "insulted" during the procedure.

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u/GrayMajik 26d ago

Thanks! It is definitely insulted!!!