title: Urinary straining contributes to inguinal hernia after radical retropubic prostatectomy.
abstract: To verify whether abdominal pressure during urination represents an important factor in the postoperative development of inguinal hernia after radical retropubic prostatectomy.
  
  
  
  Participants comprised 228 patients who underwent radical retropubic prostatectomy without prophylaxis for inguinal herniation between 2002 and 2007. Development of inguinal hernia was assessed from clinical records. Straining was rated on a six-point scale (straining score) according to frequency of straining using answers to question 6 of the International Prostate Symptom Score questionnaire preoperatively, and at 1, 3, 6, 12, 18, 24 and 36 months after prostatectomy. Straining scores were compared between patients with and without postoperative inguinal hernia. Multivariate analysis was carried out to identify parameters associated with inguinal hernia development after prostatectomy. Associations between inguinal hernia development and frequency of postoperative urinary straining were also estimated.
  
  
  
  Straining score in both groups was significantly increased at 1 month after radical retropubic prostatectomy. This increase was significantly greater in the postoperative inguinal hernia group (P < 0.05). Throughout the observation period, postoperative straining scores were higher in the group with postoperative inguinal hernia than in the group without. On multivariate analysis, postoperative urinary straining and previous hernia repair represented significant risk factors for postoperative inguinal hernia. The proportion of patients without inguinal hernia decreased significantly with increasing frequency of postoperative urinary straining.
  
  
  
  Urinary straining is associated with inguinal hernia development after radical retropubic prostatectomy.
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kaiho
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Mitsuzuka
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Izumi
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ito
authors.affiliation: Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
mesh_terms: D006552:Hernia, Inguinal / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D014555:Urination Disorders / Q000150:complications* / Q000209:etiology
keywords: inguinal hernia; postoperative complications; prostatectomy; urination; urination disorders