Inguinal hernia is a common complication in lower midline incision surgery

Area of Science:

• Urology
• Surgical Oncology
• General Surgery

Background:

• Inguinal hernia is a recognized complication following radical retropubic prostatectomy (RRP).
• The risk of inguinal hernia after other lower midline abdominal surgeries in males is less understood.

Purpose of the Study:

• To investigate the association between various lower midline incision surgeries in males and the subsequent risk of developing inguinal hernias.
• To compare the incidence of inguinal hernias after different surgical procedures with a control group.

Main Methods:

• A comparative study involving male patients who underwent open prostatectomy (n=95), pelvic lymph node dissection (n=88), or cystectomy (n=76).
• Data collected via questionnaires regarding postoperative inguinal hernia morbidity.
• Comparison with a historical cohort who underwent radical retropubic prostatectomy (n=271) and a control group of non-operated men (n=953).
• Calculation of annual attributional hernia morbidity and Kaplan-Meier hernia-free survival.

Main Results:

• The cumulative incidence and annual morbidity of inguinal hernias were significantly higher in patients who underwent lower midline incision surgeries compared to the non-operated control group.
• Higher hernia rates were observed in the early years post-surgery across all investigated procedures.
• Radical retropubic prostatectomy, open prostatectomy, pelvic lymph node dissection, and cystectomy all showed increased inguinal hernia risk.

Conclusions:

• Inguinal hernia is a common postoperative complication following all investigated lower midline incision surgeries in males.
• The risk of developing an inguinal hernia is elevated after procedures such as open prostatectomy, pelvic lymph node dissection, and cystectomy.
• These findings highlight the need for awareness and potential preventative strategies for inguinal hernias in male patients undergoing lower midline abdominal surgery.