title: Combined transurethral prostatectomy and mesh-based tension-free inguinal hernia repair.
abstract: Previous reports have recognized the benefits of combining prostatic resection and inguinal hernia repair. This study reports the surgical management of bladder-outlet obstruction with simultaneous transurethral prostatectomy and mesh-based tension-free inguinal hernia repair. A prospective study was undertaken of 31 consecutive patients seen from January 1993-December 1998 at the Western Medical Center. All surgery was performed electively under epidural anesthesia, and prophylactic antimicrobial agents were given routinely. Two hernia repair techniques were used: the mesh-plug technique and the Lichtenstein repair. Written informed consent was obtained from all patients. Over a 5-year period, in 31 consecutive patients without urinary tract infection, 36 groin hernias were diagnosed. The mean+/-SD age of patients was 65.9+/-6.3 years. Twenty-four (66.7%) hernias were direct, and 12 (33.3%) were indirect; 61.1% (22) were primary hernias, and 38.8% (14) were recurrent. The mesh-plug and Lichtenstein repair techniques were used to treat 22 (61.1%) and 14 (38.8%) hernias, respectively. Wound hematoma developed after three hernioplasties (8.3%) and wound infection in one (2.7%). Hospital stays ranged between 2 and 4 days. The mean follow-up period was 69 months. The recurrence rate was 2.7% (one hernia). Simultaneous mesh-based tension-free herniorrhaphy and transurethral prostatectomy is a reliable and safe alternative for patients with both prostate enlargement and groin hernia. Hospital stay is not affected by the combined procedure, and the infection rate is acceptably low.
authors.affiliation: Surgical Division of Medical Research Unit in Clinical Epidemiology, Specialitie Hospital Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, México. avygail@infosel.net.mx
authors.forename: A
authors.initials: A
authors.lastname: González-Ojeda
authors.forename: R
authors.initials: R
authors.lastname: Anaya-Prado
authors.forename: C
authors.initials: C
authors.lastname: Fuentes-Orozco
authors.forename: E
authors.initials: E
authors.lastname: Portilla-de-Buen
authors.forename: M I
authors.initials: MI
authors.lastname: Muciño-Hernández
authors.forename: C O
authors.initials: CO
authors.lastname: Medina-Meza
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D018570:Risk Assessment; D012494:Sampling Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome