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Updated: Aug 26, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
High incidence of inguinal hernia after radical retropubic prostatectomy
Kentaro Ichioka1, Koji Yoshimura, Noriaki Utsunomiya
1Department of Urology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
Objectives:
To assess the incidence of, and risk factors for, inguinal hernia after retropubic radical prostatectomy compared with after pelvic lymph node dissection and total cystectomy.
Methods:
A total of 155 radical prostatectomies, 35 pelvic lymph node dissections, and 56 total cystectomies were included in this study. We reviewed the charts retrospectively and evaluated the incidence of, and risk factors for, inguinal hernia after surgery using Kaplan-Meier plots and a Cox proportional hazard model.
Results:
Of 155 patients in the radical prostatectomy group, 35 patients in the pelvic lymph node dissection group, and 56 patients in the cystectomy group, 33 (21.3%), 4 (11.4%), and 3 (5.4%), respectively, developed inguinal hernias during follow-up. In the radical prostatectomy group, 27 (81.8%) of the 33 patients developed inguinal hernia within 2 years postoperatively. Multivariate Cox proportional hazard analysis revealed that prostatectomy group, past history of inguinal hernia, and body mass index of less than 23 were significant risk factors for postoperative inguinal hernia.
Conclusions:
The incidence of inguinal hernia after radical prostatectomy is not low. Urologists should realize that inguinal hernia is one of the major complications of radical prostatectomy and examine the groin preoperatively and postoperatively.
Insights
Inguinal hernia occurs in over 20% of patients after radical prostatectomy. Past hernia history and lower BMI are key risk factors for this common complication.
Area of Science:
- Urology
- Surgical Oncology
- Gastroenterology
Background:
- Inguinal hernias are a potential complication following abdominal surgery.
- Radical prostatectomy, pelvic lymph node dissection, and total cystectomy are major urological procedures.
- Understanding the incidence and risk factors for inguinal hernias post-surgery is crucial for patient care.
Purpose of the Study:
- To determine the incidence of inguinal hernias after retropubic radical prostatectomy.
- To compare inguinal hernia rates between radical prostatectomy, pelvic lymph node dissection, and total cystectomy.
- To identify significant risk factors associated with developing inguinal hernias post-surgery.
Main Methods:
- Retrospective chart review of 155 radical prostatectomies, 35 pelvic lymph node dissections, and 56 total cystectomies.
- Kaplan-Meier plots were used to analyze the time to inguinal hernia development.
- Cox proportional hazard models identified risk factors for postoperative inguinal hernias.
Main Results:
- The incidence of inguinal hernia was 21.3% after radical prostatectomy, 11.4% after pelvic lymph node dissection, and 5.4% after total cystectomy.
- In the radical prostatectomy group, 81.8% of hernias developed within two years post-surgery.
- Significant risk factors included undergoing prostatectomy, a prior history of inguinal hernia, and a body mass index below 23.
Conclusions:
- Inguinal hernia is a notable complication after radical prostatectomy, with a significant incidence.
- Urologists must be aware of this risk and incorporate pre- and post-operative groin examinations.
- Early identification and management of inguinal hernias can improve patient outcomes following radical prostatectomy.
