Incidence of inguinal hernias following radical retropubic prostatectomy

During the last decade, the number of patients undergoing radical retropubic prostatectomy (RRP) has substantially increased. Over this same time period, we have noted that a significant number of these patients have developed postoperative inguinal hernias. We sought to identify the incidence of postoperative inguinal hernias after RRP and compared this with the stated 5% incidence in the general adult male population.

Ninety-two consecutive RRPs performed by three surgeons (I.J.S., N.L.C., S.W.D.) were retrospectively reviewed. The operative reports for each patient who subsequently underwent inguinal herniorrhaphy were analyzed to determine whether the hernias were direct or indirect.

The overall incidence of postoperative inguinal hernias was 12% (11 of 92). All hernias were found within approximately 6 months of the prostatectomy. Ninety-one percent (10 of 11) of these hernias were indirect, and only 9% (1 of 11) were direct.

We believe this to be the first report in the English literature describing postoperative inguinal hernias following retropubic prostatectomy. A significantly higher incidence (12%) of inguinal hernias was noted in the postprostatectomy population compared with the general adult male population (5%). This finding suggests that inguinal hernias can be a consequence of RRP. Urologists should be cognizant of this possibility in order to screen all patients carefully prior to surgery for subtle weakness in the inguinal canal, as well as to inform patients properly of the possibility of developing an inguinal hernia after surgery.