Robot-assisted radical prostatectomy may induce inguinal hernia within the first 2 years

Abstract

At present, robot-assisted radical prostatectomy (RARP) is a gold standard in radical prostatectomy. The aim of this study was to evaluate the incidence, risk factors, and timing of occurrence of inguinal hernia (IH) after RARP.We included 427 patients with prostate cancer who underwent RARP by a single surgeon from February 2006 to August 2017. Incidence, clinical, and pathological factors were investigated to assess relationship with the development of IH.Postoperative IH occurred in 29 cases (6.79% of all RARP patients), whereas 22 cases (75.9% of all IH patients) occurred within the first 2 years. The median follow-up period was 5.2 years, and the median age of patients was 65 years. Postoperative IH occurrence was significantly associated with body mass index (BMI), smoking history, and low surgeon experience (P = .036, .023, and .048, respectively). However, low surgeon experience did not reach statistical significance after multivariate analysis.The overall incidence of IH after RARP was significantly associated with BMI and smoking history. With obvious incidence of IH within the first 2 years after operation which was not observed at the open prostatectomy, RARP itself may play a role in the development of IH.

Strategy for laparoscopic repair of inguinal hernia after robot‐assisted radical prostatectomy

“…In the era of minimally invasive surgery represented by RARP, the incidence of postoperative IH has been reported to range from 4% to 20%. [4][5][6]13,14 Risk factors reported in a previous study of IH after RARP included surgical experience, post-RARP incontinence outcomes, BMI, preoperative International Prostate Symptom Score, presence of patent processus vaginalis, age, history of previous abdominal surgery, and higher tumor stage. 14,15 In the present study, all patients with IH after RARP had external hernia, and risk factors for prostate surgery were not evaluated.…”

Impact of Retzius-sparing Versus Standard Robotic-assisted Radical Prostatectomy on Penile Shortening, Peyronie’s Disease, and Inguinal Hernia Sequelae

“…These are usually indirect hernias and manifest within 2–3 yr following surgery [5] . Disruption of Hesselbach’s triangle when releasing the bladder from the anterior abdominal wall and violating the transversalis fascia, as well as possible disruption of the deep inguinal ring, is thought to be a contributing factor [18] . During RS-RARP, the anterior abdominal wall is left undisturbed, thus avoiding these risk factors for hernia development.…”

“…During RS-RARP, the anterior abdominal wall is left undisturbed, thus avoiding these risk factors for hernia development. This is clinically significant, as development of symptomatic inguinal hernia leads to pain, poor quality of life, and potential need for surgical repair [18] . While RS-RARP was not associated with a decreased risk of inguinal hernia development on Cox proportional hazards model, given that there were no events in the RS-RARP group, we feel that this is due to a lack of overall events to make this model meaningful, which also highlights the need for further study with increased power to confirm our hypothesis.…”

Groin hernias: causes, diagnostics, and surgery

“…Возрастные дисплазии соединительной ткани и мышечных образований паховой области уменьшают функциональную защиту слабых мест и снижают сопротивляемость брюшной стенки внутрибрюшному давлению, что объясняет выполнение герниопластик чаще у людей зрелого возраста [18,19]. Появились сообщения о выявлении паховых грыж у 6,8-15,9% больных в основном в первые два года после радикальной простатэктомии [20,21].…”