Purpose: Inguinal hernias are a long-term complication of radical prostatectomy (RP). We investigated the clinical features and surgical outcomes of patients with inguinal hernias developing after RP.
Methods: We retrospectively investigated 80 patients (86 hernias) who underwent inguinal hernia repair after RP. We repaired all RP-associated inguinal hernias by the tension-free method with a mesh plug. We also retrospectively investigated 729 adult male patients (779 hernias) who underwent inguinal hernia repair as a control group.
Results: A higher proportion of the 80 post-RP patients developed right-sided hernias (53 [66%]) than the controls, which was significant. A higher proportion of the 86 post-RP hernias were indirect (76 [89%]) than the controls, which was also significant. The mean times to hernia development after robot-assisted RP, laparoscopic RP, and radical retropubic prostatectomy were 20.3, 48.9, and 73.2 months, respectively. The total complication rates did not differ significantly between the post-RP group and control group.
Conclusion: The proportion of post-RP patients with right-sided hernia was significantly higher than controls. Indirect inguinal hernias were predominant among the post-RP hernias. The mesh plug method is safe and effective for inguinal hernia repair after RP. The time from robot-assisted RP to the development of inguinal hernia was shorter than those from laparoscopic RP, and radical retropubic prostatectomy.
Keywords: Inguinal hernia; Mesh plug; Radical prostatectomy.