Laparoscopic mesh herniorrhaphy: impact on outcomes associated with radical retropubic prostatectomy.
OBJECTIVE
Laparoscopic herniorrhaphy employing non-absorbable mesh (LMH) is a frequently performed procedure for groin hernia. Multiple case reports in the urologic literature have identified LMH as a complicating factor in patients undergoing open radical retropubic prostatectomy (RRP) for prostate cancer. The purpose of this study was to review our experience and outcomes in patients with a prior LMH undergoing open RRP.


METHODS
After institutional review board approval, a retrospective review of all open RRPs performed by a single surgeon between 2003 and 2008 was used to identify patients with a history of a prior LMH. The outcomes of these patients were compared with a contemporary cohort of patients undergoing RRP by the same surgeon.


RESULTS
Eighteen patients with a prior LMH underwent RRP. Five of the 18 had bilateral LMH, with unilateral LMH in the remainder. Outcomes in this group were compared with 38 patients without prior LMH. There was no difference between the groups in terms of age, preoperative PSA, prostate size, preoperative Gleason score, or body mass index, and RRP was successfully performed in all 18 LMH patients. One of 18 patients had a postoperative complication (persistent JP drainage). Compared with the control group, differences in operative time and blood loss bordered on statistical significance.


CONCLUSIONS
Prior LMH is not a contraindication to RRP. While resulting in slightly longer operating times and higher blood loss, our experience suggests that RRP can be safely performed in these patients.
Neff
Donald A
DA
Department of Urology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
See
William A
WA
D005240:Feasibility Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013526:Surgical Mesh; D015996:Survival Rate