Introduction and Objectives
Inguinal hernia is a common complication after radical retropubic prostatectomy. We analyzed its incidence in several lower midline incision procedures. We compared the incidence and tried to figure out where it is most frequent. We also analyzed the impact of simultaneous pelvic lymph node dissection, duration of surgery and patient age.
Material and Methods
The study included 120 men, aged 65 to 75 years. They were separated in three groups of 40 patients according the type of operation: radical prostatectomy, radical prostatectomy+lymph node dissection and open prostatectomy for benign prostatic hyperplasia, respectively. Postoperative anastomotic stricture and preoperative presence of incipient inguinal hernia were exclusive criteria. The risk factors were analyzed using a Cox proportional hazards model.
The period of follow-up ranged from 10 to 137 months, with a median of 64 months. The incidence of inguinal hernia was 10% (4 of 40), 15% (5 of 40), and 2.5% (1 of 40) in radical prostatectomy, radical prostatectomy+lymph node dissection and open prostatectomy for benign prostatic hyperplasia groups, respectively. Multivariate Cox proportional hazards analysis demonstrated that open RRP, with or without performed lymph node dissection were significant risk factors for the development of inguinal hernia. The operative time and patient age showed no significant impact on the inguinal hernia appearance in our study group.
Inguinal hernia is an important postoperative complication in all lower midline incision procedures including radical retropubic prostatectomy. Simultaneous pelvic lymph node dissection, duration of surgery and age were not significant risk factors in this study. Urologists should recognize the inguinal hernia as one of the major late complications of section alta approach and examine the groin in the follow up period.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.