Prophylactic procedure for inguinal hernia after radical retropubic prostatectomy.
OBJECTIVE
The incidence of inguinal hernias (IH) after radical retropubic prostatectomy (RRP) has been reported to range from 10 to 50 %, but no prophylaxis for IH has yet been established. We proposed a prophylaxis for IH after RRP.


METHODS
A total of 180 patients underwent RRP at our hospital between 2000 and 2011. In January 2008, we started to perform a prophylaxis involving the dissection of the processus vaginalis. This procedure was performed in 73 patients. We then compared the incidence of IH between the patients that did (prophylaxis group) and did not (no prophylaxis group) undergo the prophylaxis. We also studied the risk factors for IH after RRP.


RESULTS
In the no prophylaxis group, 25 (23 %) of the 107 patients developed IH, and the IH-free rate at one postoperative year was 86 %. In contrast, only 3 (4.1 %) of the 73 patients in the prophylaxis group developed IH, resulting in IH-free rate of 96 % at one postoperative year (P = 0.0235). Among the patients in the no prophylaxis group, the mean body mass index of the hernia group was significantly lower than that of the no hernia group (P = 0.006).


CONCLUSIONS
Our results suggest that our prophylaxis is useful for preventing IH after RRP.
Department of Surgery, Tokyo Kosei Nenkin Hospital, Tokyo, Japan. rimatsun@east.ncc.go.jp.
R
R
Matsunaga
Department of Surgery, Tokyo Kosei Nenkin Hospital, Tokyo, Japan.
M
M
Negishi
Department of Surgery, Tokyo Kosei Nenkin Hospital, Tokyo, Japan.
H
H
Higashi
Department of Surgery, Tokyo Kosei Nenkin Hospital, Tokyo, Japan.
H
H
Shida
Department of Urology, Tokyo Kosei Nenkin Hospital, Tokyo, Japan.
K
K
Akakura
D000368:Aged; D015331:Cohort Studies; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007264:Inguinal Canal / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery; D012307:Risk Factors; D013085:Spermatic Cord / Q000601:surgery
Hernia-free rate; Inguinal hernia; Prophylaxis; Prostatectomy