title: Inguinal hernia after radical perineal prostatectomy: comparison with the retropubic approach.
abstract: OBJECTIVE
  To clarify the characteristics of inguinal hernia (IH) after radical perineal prostatectomy (RPP) compared with that after radical retropubic prostatectomy (RRP).
  
  
  METHODS
  We retrospectively reviewed 285 and 311 men who underwent RPP and RRP, respectively, for clinically localized prostate cancer between August 2000 and June 2006, using medical records and a telephone survey.
  
  
  RESULTS
  The incidence of postoperative IH after RPP was 1.8% (5 of 285) with a median follow-up time of 43 months; that after RRP was 10.3% (32 of 311) with a median follow-up of 36 months (P <0.0001). The cumulative IH-free rate was significantly higher after RPP than after RRP (P <0.0001, log-rank test). Three of the five RPP patients (60%) developed IH more than 24 months after surgery, whereas 25 of 32 (78%) of the RRP group did so within 24 months (P = 0.0742). The incidence rate of post-RPP IH did not differ between the standard (4 of 194 = 2.1%) and modified (1 of 91 = 1.1%) RPP procedures, where the endopelvic fascia was left intact and opened, respectively (P = 0.5638).
  
  
  CONCLUSIONS
  The incidence of IH after RPP appears to be sporadic and about the same as that (2.0-2.4%) reported previously in men with prostate cancer treated nonsurgically. Although some kinds of procedures during RRP are speculated to affect the internal inguinal ring, prostatectomy with or without opening of the endopelvic fascia seems to be less implicated in the development of IH after RRP because it was not a significant variable in IH development after different techniques had been used in RPP.
authors.affiliation: Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. matsua@hiroshima-u.ac.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Yoneda
authors.forename: Takahisa
authors.initials: T
authors.lastname: Nakamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Maruyama
authors.forename: Syuntaro
authors.initials: S
authors.lastname: Koda
authors.forename: Keisuke
authors.initials: K
authors.lastname: Goto
authors.forename: Jun
authors.initials: J
authors.lastname: Teishima
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiina
authors.forename: Mikio
authors.initials: M
authors.lastname: Igawa
authors.forename: Tsuguru
authors.initials: T
authors.lastname: Usui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D006552:Hernia, Inguinal / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery; D012307:Risk Factors