Abstract
PurposeIn addition to incisional hernia, inguinal hernia is a recognized complication to radical retropubic prostatectomy. To compare the risk of developing inguinal and incisional hernias after open radical prostatectomy compared to robot-assisted laparoscopic prostatectomy.MethodPatients planned for prostatectomy were enrolled in the prospective, controlled LAPPRO trial between September 2008 and November 2011 at 14 hospitals in Sweden. Information regarding patient characteristics, operative techniques and occurrence of postoperative inguinal and incisional hernia were retrieved using six clinical record forms and four validated questionnaires.Results3447 patients operated with radical prostatectomy were analyzed. Within 24 months, 262 patients developed an inguinal hernia, 189 (7.3%) after robot-assisted laparoscopic prostatectomy and 73 (8.4%) after open radical prostatectomy. The relative risk of having an inguinal hernia after robot-assisted laparoscopic prostatectomy was 18% lower compared to open radical retropubic prostatectomy, a non-significant difference. Risk factors for developing an inguinal hernia after prostatectomy were increased age, low BMI and previous hernia repair. The incidence of incisional hernia was low regardless of surgical technique. Limitations are the non-randomised setting.ConclusionsWe found no difference in incidence of inguinal hernia after open retropubic and robot-assisted laparoscopic radical prostatectomy. The low incidence of incisional hernia after both procedures did not allow for statistical analysis. Risk factors for developing an inguinal hernia after prostatectomy were increased age and BMI.
Highlights
Radical prostatectomy has been associated with an increased risk of inguinal hernia formation postoperatively for more than two decades
Today a majority of prostate cancer operations are performed using robot-assisted laparoscopic technique (RALP) and several authors have addressed the question whether the risk of postoperative inguinal hernia is increased to the same extent after robot-assisted laparoscopic radical prostatectomy, reporting diverging results [5, 7,8,9,10]
Patients with localized prostate cancer operated by radical prostatectomy at 14 centers in Sweden were prospectively included in the LAPPRO trial between September 2008 and November 2011
Summary
Radical prostatectomy has been associated with an increased risk of inguinal hernia formation postoperatively for more than two decades. Extended author information available on the last page of the article open retropubic radical prostatectomy (RRP) [1] that was later confirmed by several independent reports [2,3,4,5]. Today a majority of prostate cancer operations are performed using robot-assisted laparoscopic technique (RALP) and several authors have addressed the question whether the risk of postoperative inguinal hernia is increased to the same extent after robot-assisted laparoscopic radical prostatectomy, reporting diverging results [5, 7,8,9,10]
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