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Prophylactic procedure for inguinal hernia after radical retropubic prostatectomy
R Matsunaga1, M Negishi2, H Higashi2
1Department of Surgery, Tokyo Kosei Nenkin Hospital, Tokyo, Japan. rimatsun@east.ncc.go.jp.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|November 10, 2014
Summary
A new surgical technique to dissect the processus vaginalis significantly reduced inguinal hernia (IH) incidence after radical retropubic prostatectomy (RRP). This prophylaxis improved the IH-free rate, suggesting its clinical utility.
Area of Science:
- Urology
- Surgical Oncology
- Hernia Surgery
Background:
- Inguinal hernias (IH) are a common complication following radical retropubic prostatectomy (RRP), with reported incidences ranging from 10% to 50%.
- Currently, no established prophylaxis exists to prevent IH after RRP.
Purpose of the Study:
- To propose and evaluate a novel prophylactic surgical technique for preventing inguinal hernias (IH) after radical retropubic prostatectomy (RRP).
Main Methods:
- A cohort of 180 patients undergoing RRP between 2000 and 2011 was analyzed.
- From January 2008, a prophylaxis involving dissection of the processus vaginalis was implemented in 73 patients (prophylaxis group).
- The incidence of IH was compared between the prophylaxis group and a historical control group (107 patients) who did not undergo the procedure. Risk factors for IH were also investigated.
Main Results:
- The incidence of IH was significantly lower in the prophylaxis group (4.1%) compared to the no prophylaxis group (23%), with a one-year IH-free rate of 96% versus 86% (P = 0.0235).
- Lower mean body mass index was identified as a risk factor for IH in the no prophylaxis group (P = 0.006).
Conclusions:
- The proposed prophylaxis, involving dissection of the processus vaginalis, appears effective in reducing the incidence of inguinal hernias after RRP.
- This surgical approach may offer a valuable strategy for preventing IH in patients undergoing prostatectomy.
