What Is Pleurodesis?

Here's the frustrating pattern that leads most people to this procedure: the fluid around the lung gets drained, breathing eases — and a few weeks later the fluid is back, and so is the breathlessness. Or a lung collapses, gets treated, and then collapses again. Pleurodesis is the step doctors take when draining alone isn't holding. Instead of just removing the air or fluid, it seals the space it keeps collecting in, so there's nowhere for it to return to. The short video at the top of this page, titled simply "Pleurodesis," runs for a little under two minutes and shows the keyhole, camera-guided version of the operation — worth a look before you read on, because seeing the inside of the chest makes the idea of "sealing a space" much more concrete.

The space being sealed, in plain terms

Your lungs sit inside the chest wall, and between the lung and the wall there's a thin potential space — the pleural space — lined on both sides by a smooth membrane called the pleura. Normally it holds only a slick of fluid, just enough to let the lung glide as you breathe. Problems start when that space fills with something it shouldn't: air, in a collapsed lung — our guide to pneumothorax explains how that happens — or excess fluid, which is a pleural effusion. Draining either one relieves the pressure, but drainage doesn't change the space itself. Pleurodesis does: it deliberately irritates the two pleural layers so that, as they heal, they stick together and the space is effectively closed off.

When a team might suggest it

You'll usually hear the word only after the simpler step has already been tried. The common situations are a pneumothorax that keeps coming back, a pleural effusion that refills after drainage, or an effusion linked to an ongoing condition where repeat drainage visits are becoming a burden in themselves. It's a judgement call, not an automatic next step: your team weighs how often the problem has returned, how your lungs are overall, and whether the lung can re-expand fully against the chest wall — because pleurodesis only works if the two layers can actually meet. If that conversation is happening for you, it's reasonable to ask what the plan would be without it, which usually means repeat drainage, an indwelling drain, or watchful waiting.

What to expect on the day

There are two broad routes, and the video on this page shows one of them. In the surgical route, the procedure is done under general anaesthetic using the keyhole chest approach our guide to VATS describes: a camera and small instruments pass through small cuts between the ribs, any remaining fluid is cleared, and the surgeon creates the irritation that triggers the sticking — in the anchor video, that means applying sterile talc across the pleural surface, which is why you'll hear the phrase "talc pleurodesis." The second video on this page, "Video-assisted thoracoscopic surgery (VATS)", is an overview of about three minutes and twenty seconds that puts that in context: it notes that for a spontaneous pneumothorax in someone with severe underlying lung disease, a chest drain is the first procedure of choice, and that pleurodesis lowers the chance of the collapse returning. In the non-surgical route, sometimes called chemical or medical pleurodesis, you're awake, and the irritant is given through a chest drain that's already in place. Either way, expect a chest tube to stay in for a time afterwards, draining while the layers settle against each other.

Afterwards: recovery and the honest limits

Most people stay in hospital for some days, largely while the drain is in and the team confirms on X-ray that the lung is staying up and the fluid isn't re-collecting. Soreness around the drain site and a temporary feverish, flu-like feeling are commonly described in the first day or two — the irritation that makes the treatment work is, by design, an inflammatory process, and pain relief is part of the care. And here's the limit worth hearing plainly: pleurodesis reduces the chance of the problem returning; it doesn't guarantee it never will, and it doesn't treat whatever caused the fluid or air leak in the first place. That underlying cause still needs its own follow-up. Call your team promptly afterwards for worsening breathlessness, chest pain that is getting worse rather than better, fever, or redness spreading around the drain site.

References & further reading

- MedlinePlus — Pleural Disorders: https://medlineplus.gov/pleuraldisorders.html
- MedlinePlus — Collapsed Lung: https://medlineplus.gov/collapsedlung.html
- Cleveland Clinic — Pleurodesis: Procedure, Types & Recovery: https://my.clevelandclinic.org/health/treatments/pleurodesis

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Is pleurodesis the same as draining the fluid?
No. Drainage removes the air or fluid that's already there. Pleurodesis goes a step further: it seals the pleural space itself, so air or fluid has nowhere to collect again.

Does pleurodesis hurt?
The surgical route is done under general anaesthetic, so you won't feel the procedure itself. Afterwards, soreness around the drain site and a brief feverish feeling are commonly described, and pain relief is part of the hospital care.

Can pleurodesis fail?
It can. It lowers the chance of the air or fluid coming back, but it doesn't remove that chance completely, and it only works when the lung can re-expand so the pleural layers meet. Your team can talk through what the next options would be if it didn't hold.

How long will I be in hospital?
Often some days, mostly while the chest drain stays in and X-rays confirm the lung is staying expanded. The exact length varies with the reason for the procedure and how quickly drainage settles, so ask your own team for their expected range.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. Worsening breathlessness or chest pain needs prompt medical assessment.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/07/26