Incidence of Groin Hernia Repair After Radical Prostatectomy

Nilsson, Hanna; Stranne, Johan; Stattin, Pär; Nordin, Pär

doi:10.1097/sla.0b013e3182975c88

Cited by 51 publications

(38 citation statements)

References 29 publications

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“…It has been suggested that it is the lower midline incision that induces the inguinal hernia formation and that all surgery performed by a lower midline incision could cause this complication [6]. Today a majority of prostate cancer operations are performed using robot-assisted laparoscopic technique (RALP) and hence several authors have addressed the question whether the risk of postoperative inguinal hernia is increased to the same extent after robot-assisted laparoscopic radical prostatectomy, reporting diverging results [5,[7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial

Nilsson

Stranne

Hugosson

et al. 2020

Hernia

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Purpose In addition to incisional hernia, inguinal hernia is a recognized complication to radical retropubic prostatectomy. To compare the risk of developing inguinal and incisional hernias after open radical prostatectomy compared to robot-assisted laparoscopic prostatectomy. Method Patients planned for prostatectomy were enrolled in the prospective, controlled LAPPRO trial between September 2008 and November 2011 at 14 hospitals in Sweden. Information regarding patient characteristics, operative techniques and occurrence of postoperative inguinal and incisional hernia were retrieved using six clinical record forms and four validated questionnaires. Results 3447 patients operated with radical prostatectomy were analyzed. Within 24 months, 262 patients developed an inguinal hernia, 189 (7.3%) after robot-assisted laparoscopic prostatectomy and 73 (8.4%) after open radical prostatectomy. The relative risk of having an inguinal hernia after robot-assisted laparoscopic prostatectomy was 18% lower compared to open radical retropubic prostatectomy, a non-significant difference. Risk factors for developing an inguinal hernia after prostatectomy were increased age, low BMI and previous hernia repair. The incidence of incisional hernia was low regardless of surgical technique. Limitations are the non-randomised setting.Conclusions We found no difference in incidence of inguinal hernia after open retropubic and robot-assisted laparoscopic radical prostatectomy. The low incidence of incisional hernia after both procedures did not allow for statistical analysis. Risk factors for developing an inguinal hernia after prostatectomy were increased age and BMI.

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Section: Introductionmentioning

confidence: 99%

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial

Nilsson

Stranne

Hugosson

et al. 2020

Hernia

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“…They also reported an almost fourfold increase in IH repair after open RP compared with controls, and men who underwent radiation therapy had an almost twofold increase in IH incidence. In addition to postoperative changes in the abdominal wall, there is an increased incidence of IH after RP or radiation therapy for prostate cancer …”

Section: Ih Development After Rpmentioning

confidence: 99%

“…Their results showed that the processus vaginalis transection procedure was superior to the simpler prophylactic procedure for the prevention of IH after RP. Recent trends in surgery for prostate cancer including robotic‐assisted surgery have been reported to reduce IH occurrence rates . In the future, we will need to focus on robotic surgery‐associated IH.…”

Section: Preventive Measures From Open Surgery To Robotic Surgerymentioning

confidence: 99%

“…In addition to postoperative changes in the abdominal wall, there is an increased incidence of IH after RP or radiation therapy for prostate cancer. 13 Zhu et al performed a meta-analysis of 29 trials, and reported that postoperative IH developed in 15.9% of patients who underwent open RP and 6.7% (4.8-8.6) of those who underwent laparoscopic RP. Most cases of IH occurred within the first 2 years after surgery, and right-side and indirect-type IH predominated.…”

Section: Ih Development After Rpmentioning

confidence: 99%

“…Recent trends in surgery for prostate cancer including robotic-assisted surgery have been reported to reduce IH occurrence rates. 13 In the future, we will need to focus on robotic surgery-associated IH.…”

Section: Ih Development After Rpmentioning

confidence: 99%

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Inseparable interaction of the prostate and inguinal hernia

Miyajima

2018

Int J of Urology

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With an increase in their prevalence, it has become apparent that both benign prostatic hyperplasia and radical prostatectomy for cancer can induce inguinal hernia development. An inguinal hernia is a common late complication following radical prostatectomy, with an occurrence rate of 12-25%. Following radical prostatectomy, the space of Retzius can develop adhesions to surrounding tissue, often causing difficulty during inguinal hernia repair. Conversely, inguinal hernia repair before radical prostatectomy also induces severe adhesions around the space of Retzius and causes difficulty during radical prostatectomy. The association between radical prostatectomy and inguinal hernia development is complex and unclear. Both urologists and surgeons are challenged by this interaction. The surgical approaches for prostate cancer have undergone a major transition from open surgery to robotic surgery, and the treatment of inguinal hernia is also changing. Based on historical trends, several preventive and treatment measures have been proposed, although there is no direct evidence for risk factors that lead to inguinal hernia development. This article focuses on the complex interaction between the prostate and inguinal hernia, and considers preventive measures against inguinal hernia development.

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Long‐term adverse effects after retropubic and robot‐assisted radical prostatectomy. Nationwide, population‐based study

Fridriksson

Folkvaljon

Lundström

et al. 2017

Journal of Surgical Oncology

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Background and ObjectivesSurgery for prostate cancer is associated with adverse effects. We studied long‐term risk of adverse effects after retropubic (RRP) and robot‐assisted radical prostatectomy (RARP).MethodsIn the National Prostate Cancer Register of Sweden, men who had undergone radical prostatectomy (RP) between 2004 and 2014 were identified. Diagnoses and procedures indicating adverse postoperative effects were retrieved from the National Patient Register. Relative risk (RR) of adverse effects after RARP versus RRP was calculated in multivariable analyses adjusting for year of surgery, hospital surgical volume, T stage, Gleason grade, PSA level at diagnosis, patient age, comorbidity, and educational level.ResultsA total of 11 212 men underwent RRP and 8500 RARP. Risk of anastomotic stricture was lower after RARP than RRP, RR for diagnoses 0.51 (95%CI = 0.42‐0.63) and RR for procedures 0.46 (95%CI = 0.38‐0.55). Risk of inguinal hernia was similar after RARP and RRP but risk of incisional hernia was higher after RARP, RR for diagnoses 1.48 (95%CI = 1.01‐2.16), and RR for procedures 1.52 (95%CI = 1.02‐2.26).ConclusionsThe postoperative risk profile for RARP and RRP was quite similar. However, risk of anastomotic stricture was lower and risk of incisional hernia higher after RARP.

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Incidence of Groin Hernia Repair After Radical Prostatectomy

Cited by 51 publications

References 29 publications

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial

Inseparable interaction of the prostate and inguinal hernia

Long‐term adverse effects after retropubic and robot‐assisted radical prostatectomy. Nationwide, population‐based study

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