title: Inguinal hernia after radical prostatectomy for prostate cancer: results from a randomized setting and a nonrandomized setting.
abstract: BACKGROUND
  Observational data indicate that retropubic radical prostatectomy (RRP) for prostate cancer (PCa) may induce inguinal hernia (IH) formation. Little is known about the influence of robot-assisted radical prostatectomy (RALP) on IH risk.
  
  
  OBJECTIVE
  To compare the incidence of IH after RRP and RALP to that of nonoperated patients with PCa and to a population control.
  
  
  METHODS
  We studied two groups. All 376 men included in the Scandinavian Prostate Cancer Group Study Number 4 constitute study group 1. Patients were randomly assigned RRP or watchful waiting (WW). The 1411 consecutive patients who underwent RRP or RALP at Karolinska University Hospital constitute study group 2. Men without PCa, matched for age and residence to each study group, constitute controls.
  
  
  METHODS
  Postoperative IH incidence was detected through a validated questionnaire. The participation rates were 82.7% and 88.4% for study groups 1 and 2, respectively.
  
  
  CONCLUSIONS
  The Kaplan-Meier cumulative occurrence of IH development after 48 mo in study group 1 was 9.3%, 2.4%, and 0.9% for the RRP, the WW, and the control groups, respectively. There were statistically significant differences between the RRP group and the WW and control groups, but not between the last two. In study group 2 the cumulative risk of IH development at 48 mo was 12.2%, 5.8%, and 2.6% for the RRP, the RALP, and the control group, respectively. There were statistically significant differences between the RRP group and the RALP and control groups, but not between the last two.
  
  
  CONCLUSIONS
  RRP for PCa leads to an increased risk of IH development. RALP may lower the risk as compared to open surgery.
authors: Department of Oncology and Pathology, Division of Clinical Cancer Epidemiology, Karolinska Institute, Stockholm, Sweden. johan.stranne@vgregion.se
authors: Johan
authors: J
authors: Stranne
authors: Eva
authors: E
authors: Johansson
authors: Andreas
authors: A
authors: Nilsson
authors: Anna
authors: A
authors: Bill-Axelson
authors: Stefan
authors: S
authors: Carlsson
authors: Lars
authors: L
authors: Holmberg
authors: Jan-Erik
authors: JE
authors: Johansson
authors: Tommy
authors: T
authors: Nyberg
authors: Mirja
authors: M
authors: Ruutu
authors: N Peter
authors: NP
authors: Wiklund
authors: Gunnar
authors: G
authors: Steineck
mesh_terms: D000368:Aged; D018849:Controlled Clinical Trials as Topic / Q000706:statistics & numerical data; D006552:Hernia, Inguinal / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012307:Risk Factors; D012371:Robotics / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D057832:Watchful Waiting / Q000706:statistics & numerical data