Concurrent radical retropubic prostatectomy and Lichtenstein inguinal hernia repair through a single modified Pfannenstiel incision: a 3‐year experience

Abstract

inguinal canal through the same incision and performed a Lichtenstein mesh repair, through the inguinal canal and avoiding placing mesh within the pelvis. Patients were followed at 1 and 6 weeks, 3-monthly for 1 year and 6-monthly thereafter. All clinical variables were entered into a database and analysed. RESULTSIn all, 450 men underwent RRP; 44 (10%) had inguinal hernia and in all, 56 hernias were repaired (32 unilateral and 12 bilateral; 16 indirect, 22 direct, six both) The mean ( SD ) age of the patients was 60 (7) years. Most patients were discharged within 36 h. The mean ( SD ) follow-up was 9 (8) months. Two patients had a superficial inguinal haematoma and one had a scrotal haematoma. They were treated conservatively with no sequelae. There were no wound infections. One patient developed a recurrent inguinal hernia. None had any clinical evidence of testicular atrophy or chronic pain. CONCLUSIONConcurrent formal mesh repair of the inguinal hernia and RRP through a single modified Pfannenstiel incision is safe and effective. The complications were minimal and recurrence rates were low. This procedure eliminates the risks involved with the preperitoneal mesh repair and avoids multiple incisions.

Anterior Abdominal Wall Hernias and Andrological Disorders. Relationship, Some Problems of Epidemiology, Aetiology, and Simultaneous Surgeries (Literature Review)

“…По мнению многих зарубежных коллег, проведение одновременной радикальной позадилонной простат-эктомии с протезированием пахового канала из еди-ного модифицированного разреза по Пфанненштилю является эффективным и безопасным [5,21]. А. Б. Си-пенко и соавт.…”

“…Один из них -повышение внутрибрюшного давления, которое регистрируют при ДГПЖ или РПЖ [4,5]. Поэтому многие авторы считают, что при сочетании этих забо-леваний с вентральной или паховой грыжей необходи-мо проведение одномоментного оперативного вмеша-тельства [5][6][7][8][9]. Более 30 % пациентов с грыжей имеют различные признаки дисплазии соединительной ткани (ДСТ), что необходимо учитывать при выполнении оперативного вмешательства.…”

Outcomes after concurrent inguinal hernia repair and robotic-assisted radical prostatectomy

“…The concomitant repair of inguinal hernias during prostatectomy has been well described with reports of satisfactory outcomes in both open and laparoscopic RP [9,13,14]. However, as robotic-assisted laparoscopic radical prostatectomy (RALP) continues to grow in popularity across the globe, attention has turned to the management of inguinal hernias during this procedure.…”

Modified Pfannenstiel approach for radical retropubic prostatectomy: a 3-year experience

“…This Y approach prevents any inadvertent entry into inguinal canal and also facilitates concurrent inguinal hernia repair through the same incision. 8,24 This modification also reduces the chance of ilio inguinal and ilio hypogastric nerve entrapment, which is a known complication of classical Pfannenstiel approach. 25 Salonia et al, 26 in a prospective randomized study, concluded that outcome after Pfannenstiel approach for a RRP was not significantly different from a vertical midline incision.…”

“…There were no major complications and only one patient had recurrence of a hernia. 24 We also performed penile prosthesis insertion in two patients through the same incision.…”