Our Summary

This research paper discusses the risk of developing a type of hernia known as an inguinal hernia following a prostate removal surgery (radical prostatectomy). Certain factors like previous hernia repair, wound infection, the type of incision used in surgery, low body mass index, and existing or underlying hernia increase this risk.

The paper also examines the pros and cons of repairing a hernia at the same time as the prostate surgery. On one hand, fixing the hernia during the same procedure can avoid future complications related to the hernia and eliminates the need for a separate surgery. However, it also carries risks such as infection of the mesh used in the repair, post-surgery pain, adhesions (bands of scar tissue that can cause organs to stick together), lack of experience by the surgeon, and a minimal risk associated with simply monitoring the hernia without immediate surgery.

The paper suggests that using a robotic procedure that goes through the abdominal cavity is the most common method for repairing a hernia during prostate surgery. This method only slightly increases the surgery time and has minimal complications after surgery. The chances of the hernia reoccurring after this combined surgery is also very low.

FAQs

  1. What factors contribute to the risk of inguinal hernia after radical prostatectomy?
  2. What are the risks and benefits of concomitant hernia repair during radical prostatectomy?
  3. What is the most commonly used technique for concomitant inguinal hernia repair and what are its associated risks?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hernia repair is to discuss the option of concomitant hernia repair during pelvic surgery, such as a radical prostatectomy. This can prevent future hernia-related complications and save the need for an additional procedure. However, it is important to weigh the risks and benefits with your surgeon before making a decision. Additionally, the robotic transperitoneal approach is a commonly used technique for concomitant hernia repair with minimal postoperative complications.

Suitable For

Patients who are typically recommended for hernia repair include those with a history of previous hernia repair, wound infection, midline incision, low body mass index, and preexisting or subclinical hernia. Additionally, patients undergoing pelvic surgery, such as radical prostatectomy, may be recommended for concomitant hernia repair to prevent future complications and the need for an additional procedure. The robotic transperitoneal approach is commonly used for concomitant hernia repair with low recurrence rates and minimal postoperative complications.

Timeline

Before hernia repair:

  • Patient may experience symptoms such as a bulge in the groin area, pain or discomfort, especially when coughing, lifting heavy objects, or standing for long periods of time.
  • Consultation with a healthcare provider to diagnose the hernia and discuss treatment options.
  • Pre-operative evaluation to assess the patient’s overall health and fitness for surgery.
  • Surgical consent form signed by the patient after discussing the risks and benefits of the procedure.

After hernia repair:

  • Recovery period varies depending on the type of hernia repair (open or laparoscopic) and the patient’s overall health.
  • Post-operative care instructions provided, including pain management, wound care, and activity restrictions.
  • Follow-up appointments scheduled to monitor the healing process and check for any complications.
  • Gradual return to normal activities and exercise as advised by the healthcare provider.
  • Long-term follow-up to monitor for recurrence of the hernia and address any persistent symptoms.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing hernia repair at the same time as my prostate surgery?

  2. Will the hernia repair be performed using a laparoscopic or robotic approach?

  3. What is the success rate of hernia repair during prostate surgery in terms of preventing future hernia-related complications?

  4. What is the likelihood of developing complications such as mesh infection, postoperative pain, or adhesions after concomitant hernia repair?

  5. How much additional time will be added to my surgery for the hernia repair?

  6. What is the experience level of the surgical team in performing concomitant hernia repair during prostate surgery?

  7. Are there any alternative treatment options for the hernia that I should consider?

  8. What is the likelihood of hernia recurrence after undergoing concomitant repair during prostate surgery?

  9. How long is the recovery time expected to be for both the prostate surgery and hernia repair?

  10. Are there any specific postoperative instructions or precautions I should follow to prevent complications after the hernia repair?

Reference

Authors: Kaler K, Vernez SL, Dolich M. Journal: J Endourol. 2016 Oct;30(10):1036-1040. doi: 10.1089/end.2016.0225. Epub 2016 Aug 30. PMID: 27575356