Incidence and risk factors of inguinal hernia after robot-assisted radical prostatectomy

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Abstract

Background

Robot-assisted radical prostatectomy (RARP) has now become a gold standard approach in radical prostatectomy. The aim of this study was to investigate incidence and risk factors of inguinal hernia (IH) after RARP.

Methods

This study included 307 consecutive men who underwent RARP for the treatment of prostate cancer from January 2011 to August 2015. The incidence of IH after RARP was investigated. Clinical and pathological factors were also investigated to assess relationship with development of postoperative IH.

Results

Median follow-ups were 380 days, and median age of patients was 67 years. Incidence of IH was 11.3, 14.0, and 15.4% at 1, 2, and 3 years after RARP, respectively. Postoperative IH occurrence was significantly associated with low surgeon experience and postoperative incontinence at 3 or 6 months after surgery ( P = 0.019, P = 0.002, and P = 0.016, respectively).

Conclusions

Most of the IH occurred within the first 2 years with a rate of 14%. Incidence of IH after RARP was significantly associated with surgical experience and incontinence outcomes.

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Most cited references 21

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Patient-related risk factors for recurrence after inguinal hernia repair: a systematic review and meta-analysis of observational studies.

Jakob Burcharth, Hans-Christian Pommergaard, Thue Bisgaard … (2015)

Several factors influence the risk of recurrence after inguinal hernia surgery; however, a systematic review and meta-analysis of patient-related risk factors for recurrence after inguinal hernia surgery has not been performed earlier.

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Body mass index and groin hernia: a 34-year follow-up study in Swedish men.

Ulf Angerås, Annika Rosengren, Anders Rosemar (2008)

Inguinal hernias are very common disorders, especially in men, with inguinal herniorrhaphy being one of the most frequently performed general surgical procedures in men. Theoretically, obesity might increase the risk of groin hernia by increasing intra-abdominal pressure. The objective of the present study was to investigate whether overweight and obesity in middle age could significantly predict future groin hernia in men. Prospective cohort study; General population of men living in Gothenburg, Sweden; A community-based sample of 7483 men aged 47 to 55 years were followed-up from baseline (1970-1973) for a maximum of 34 years. A diagnosis of groin hernia according to the Swedish hospital discharge register. A total of 1017 men (13.6%) were diagnosed with groin hernia. An inverse relationship was found between body mass index (BMI) and risk of groin hernia. With each BMI unit (3-4 kg), the relative risk for groin hernia decreased by 4% (P < 0.0001). Compared with men of normal weight, obese men had a 43% lower risk (P = 0.0008, 95% confidence interval 21%-59%). Heavy smokers demonstrated a 26% lower risk for groin hernia (P = 0.003, 95% confidence interval 10%-39%). Diabetes, high physical activity, and blood pressure were not associated with groin hernia. Entering other variables potentially associated with groin hernia, as age, BMI, smoking, and serum cholesterol, in a multivariable analysis left the risk estimates for BMI and smoking virtually unchanged. In a large community-based sample of middle-aged men overweight and obesity were associated with a lower risk for groin hernia during an extended follow-up. Obesity, in comparison with normal weight, reduced the risk of groin hernia by 43%. A reduced risk of groin hernia was also noted in heavy smokers. Obviously, hernia may be more easily detected in lean men but a true protective effect cannot be excluded.

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Vattikuti Institute prostatectomy: technical modifications in 2009.

Mani Menon, Alok K. Shrivastava, Mahendra Bhandari … (2009)

Since we last published our technique of robotic prostatectomy, we have introduced three technical refinements: superveil nerve sparing, bladder drainage with a percutaneous suprapubic tube (PST), and limited node dissection of the obturator and internal iliac nodes in preference to the external iliac nodes in selected patients. To describe selection criteria, to explain the three techniques, and to evaluate functional and oncologic results. Single-institution study of 1151 radical prostatectomies performed from 2006 to 2008 by one surgeon. The superveil nerve-sparing technique spares nerves from the 11-o'clock position to the 1-o'clock position. The bladder is drained with a PST rather than a urethral catheter. For low- or intermediate-risk disease, limited lymphadenectomy concentrates on the internal iliac and obturator nodes, excluding the external iliac lymph nodes. Erectile function and patient comfort were evaluated using questionnaires administered by a third party. Lymph node yield was quantified by a qualified uropathologist. At 6-18 months after surgery, 94% of men who attempted sexual intercourse were successful with a median Sexual Health Inventory For Men (SHIM) score of 18 out of 25. PST bladder drainage resulted in less patient discomfort; visual analog scores were 2 at 2 days after prostatectomy and 0 at 6 days after prostatectomy. The modified lymphadenectomy harvested few overall nodes, but it increased the yield of positive nodes >13-fold in patients with low-risk stratification (6.7% compared with 0.5%). In this single-institution, single-surgeon study, these modifications improved erectile function outcomes, decreased catheter-associated discomfort, and enhanced the detection of positive nodes.

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Author and article information

Contributors

Yuta Yamada: yyamada2029@gmail.com

Tetsuya Fujimura: 81-3-5800-8662 , fujimurat-uro@h.u-tokyo.ac.jp

Hiroshi Fukuhara: fukuharah-uro@h.u-tokyo.ac.jp

Toru Sugihara: ezy04707@nifty.com

Kotaro Takemura: hama_irino@yahoo.co.jp

Shigenori Kakutani: kakushigean@yahoo.co.jp

Motofumi Suzuki: suzukim-uro@h-u-tokyo.ac.jp

Tohru Nakagawa: tohru-tky@umin.ac.jp

Haruki Kume: kume@kuc.biglobe.ne.jp

Yasuhiko Igawa: yigawa-jua@umin.ac.jp

Yukio Homma: homma-uro@umin.ac.jp

Journal

Journal ID (nlm-ta): World J Surg Oncol

Journal ID (iso-abbrev): World J Surg Oncol

Title: World Journal of Surgical Oncology

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7819

Publication date (Electronic): 16 March 2017

Publication date PMC-release: 16 March 2017

Publication date Collection: 2017

Volume: 15

Electronic Location Identifier: 61

Affiliations

[1 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Department of Urology, Graduate School of Medicine, , The University of Tokyo, ; Hongo7-3-1, Bunkyo-ku, Tokyo, Japan

[2 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Continence Medicine, Graduate School of Medicine, , The University of Tokyo, ; Bunkyo-ku, Tokyo, Japan

[3 ]ISNI 0000 0001 0016 1697, GRID grid.414994.5, Department of Urology, , Tokyo Teishin Hospital, ; Chiyoda-ku, Tokyo, Japan

Article

Publisher ID: 1126

DOI: 10.1186/s12957-017-1126-3

PMC ID: 5353804

PubMed ID: 28302122

SO-VID: 2b7f2ad1-1d95-4935-950d-bc6f66acb23c

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 29 December 2016

Date accepted : 6 March 2017

Custom metadata

ScienceOpen disciplines: Surgery

Keywords: inguinal hernia,prostate cancer,radical prostatectomy,robot-assisted radical prostatectomy

Data availability:

ScienceOpen disciplines: Surgery

Keywords: inguinal hernia, prostate cancer, radical prostatectomy, robot-assisted radical prostatectomy

Incidence and risk factors of inguinal hernia after robot-assisted radical prostatectomy

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Abstract

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Results

Conclusions

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Most cited references 21

Patient-related risk factors for recurrence after inguinal hernia repair: a systematic review and meta-analysis of observational studies.

Body mass index and groin hernia: a 34-year follow-up study in Swedish men.

Vattikuti Institute prostatectomy: technical modifications in 2009.

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