title: Incidence of groin hernia repair after radical prostatectomy: a population-based nationwide study.
abstract: OBJECTIVE
  To assess the incidence of groin hernia repair after radical prostatectomy for prostate cancer compared with the incidence in a control population without prostate cancer in a nationwide, population-based study.
  
  
  BACKGROUND
  Recent reports indicate an increase in the incidence of groin hernia repair after radical prostatectomy. Inadequate knowledge of the incidence of groin hernia in the general population makes this information hard to interpret.
  
  
  METHODS
  Information was retrieved from the Prostate Cancer Database (PCBaSe) and Swedish Hernia Register for events between 1998 and 2010. The incidence of groin hernia surgery was calculated for a group of men treated with radical prostatectomy (open and minimally invasive) and for a group treated with radiation therapy, and these were compared with the incidence in a control cohort of men matched for age and county of residence. Multivariate analysis was used to assess the hazard ratio (HR) of groin hernia repair according to age, tumor risk category, and Charlson Comorbidity Index.
  
  
  RESULTS
  A total of 28,608 cases and 105,422 controls were included in the study. Men treated with radical prostatectomy and radiation therapy had a significantly higher incidence of groin hernia repair than the control cohort: HR: 3.95 (95% confidence interval: 3.70-4.21) for retropubic prostatectomy, HR: 3.37 (95% confidence interval: 2.95-3.87) for minimally invasive prostatectomy, and HR: 1.84 (95% confidence interval: 1.66-2.04) for radiation therapy.
  
  
  CONCLUSIONS
  An almost 4-fold increase in groin hernia repair was observed after radical prostatectomy compared with controls, and men who received radiation therapy had an almost 2-fold increase in incidence. As well as postoperative changes in the abdominal wall, increased vigilance for groin hernia seems to be important for the increased incidence of groin hernia repair seen after radical prostatectomy or radiation therapy for prostate cancer.
authors.affiliation: *Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden †Departments of Surgery ‡Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg Sweden §Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden ¶Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY ∥Department of Surgery, Östersund Hospital, Östersund, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Nilsson
authors.forename: Johan
authors.initials: J
authors.lastname: Stranne
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.forename: Pär
authors.initials: P
authors.lastname: Nordin
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D059685:Herniorrhaphy / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011183:Postoperative Complications; D011379:Prognosis; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology