Inguinal hernia associated with radical prostatectomy
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ORIGINAL ARTICLE
Inguinal hernia associated with radical prostatectomy Satoru Nagatani1 · Hiroaki Tsumura1 · Tetsuya Kanehiro1 · Hiroaki Yamaoka1 · Yasuko Kameda1 Received: 24 March 2020 / Accepted: 8 September 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose Inguinal hernias are a long-term complication of radical prostatectomy (RP). We investigated the clinical features and surgical outcomes of patients with inguinal hernias developing after RP. Methods We retrospectively investigated 80 patients (86 hernias) who underwent inguinal hernia repair after RP. We repaired all RP-associated inguinal hernias by the tension-free method with a mesh plug. We also retrospectively investigated 729 adult male patients (779 hernias) who underwent inguinal hernia repair as a control group. Results A higher proportion of the 80 post-RP patients developed right-sided hernias (53 [66%]) than the controls, which was significant. A higher proportion of the 86 post-RP hernias were indirect (76 [89%]) than the controls, which was also significant. The mean times to hernia development after robot-assisted RP, laparoscopic RP, and radical retropubic prostatectomy were 20.3, 48.9, and 73.2 months, respectively. The total complication rates did not differ significantly between the post-RP group and control group. Conclusion The proportion of post-RP patients with right-sided hernia was significantly higher than controls. Indirect inguinal hernias were predominant among the post-RP hernias. The mesh plug method is safe and effective for inguinal hernia repair after RP. The time from robot-assisted RP to the development of inguinal hernia was shorter than those from laparoscopic RP, and radical retropubic prostatectomy. Keywords Inguinal hernia · Radical prostatectomy · Mesh plug
Introduction
Methods
The incidence of prostate cancer is increasing, and inguinal hernias are common among males with prostate cancer. Inguinal hernias are now considered a long-term complication of radical prostatectomy (RP). In 1996, Regan et al. reported that inguinal hernia developed in 12% of patients after radical retropubic prostatectomy (RRP) [1]. Since then, the surgical procedure for RP has changed. Laparoscopic RP (LRP) and robot-assisted RP (RARP) have now become standard approaches. We herein report the clinical features and surgical outcomes of patients with inguinal hernias that developed after RP.
We retrospectively investigated patients who underwent surgery for inguinal hernia associated with RP between June 2008 and July 2019 at Hiroshima City Funairi Citizens Hospital. We repaired all RP-related inguinal hernias by the tension-free method with a mesh plug (MP). We retrospectively investigated all adult male patients who underwent surgery for inguinal hernia between August 2015 and July 2019 at Hiroshima City Funairi Citizens Hospital as the control patients. We used the MP, Kugel, conventional repair, and laparoscopic transabdominal preperitoneal (TAPP) methods to repair the inguinal hernias. Patients undergoing TAPP re
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