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Simple method of preventing postoperative inguinal hernia after radical retropubic prostatectomy

Authors :
Hiromichi Naruyama
Atsushi Okada
Katsuhiro Fukuta
Keiichi Tozawa
Yasuyuki Yamada
Daichi Kobayashi
Hiroki Kubota
Kazumi Taguchi
Takahiro Yasui
Kenjiro Kohri
Source :
Urology. 76(5)
Publication Year :
2009

Abstract

OBJECTIVES To establish a novel and simple method of preventing post-retropubic prostatectomy (RRP) inguinal hernia. Inguinal hernias occur in 8%-22% of men within 1-2 years of RRP. Although manipulation during RRP might weaken the normal fascia structure at the internal inguinal ring with the vas deferens, the exact mechanism of post-RRP inguinal hernia remains unknown. METHODS Several surgeons performed RRP at our hospital on 271 patients between April 2004 and September 2009. Among these patients, post-RRP measures to prevent inguinal hernia were applied to 101 patients (group A) and not applied to 170 patients (group B). We released the bilateral spermatic cord from the peritoneum before suturing the wound, which should prevent the intestinal tract coated with the peritoneum from pushing through the internal inguinal tract. We compared the incidence of postoperative inguinal hernia between the 2 groups. RESULTS The patients were followed up for an average of 11.6 (range: 2-22 months) and 23.9 (range: 23-24 months) months in groups A and B, respectively. Inguinal hernia developed in no patients in group A and in 20 (11.8%) in group B. The hernia-free rate was significantly lower in group B than group A. All postoperative inguinal hernias were indirect. The median interval between surgery and hernia diagnosis was 10.6 months (range, 2-24), and 16 patients (80%) were diagnosed within 12 months. CONCLUSIONS We developed a simple method of preventing inguinal hernia after RRP. Our technique is simple enough to complete within a few minutes, and the outcome is excellent.

Details

ISSN :
15279995
Volume :
76
Issue :
5
Database :
OpenAIRE
Journal :
Urology
Accession number :
edsair.doi.dedup.....6b1ff53b4ef88b3c14e8b34ecd7d21f8