Radical Retropubic Prostatectomy Research Articles

Risk of Recurrent Disease 6 Years After Open or Robotic-assisted Radical Prostatectomy in the Prospective Controlled Trial LAPPRO

BackgroundConclusive evidence of superiority in oncological outcome for robot-assisted laparoscopic prostatectomy (RALP) over retropubic radical prostatectomy (RRP) is lacking. ObjectiveTo compare RALP and RRP regarding recurrent disease and to report the mortality rate 6 yr after surgery. Design, setting, and participantsA total of 4003 men with localized prostate cancer were enrolled between 2008 and 2011 in Laparoscopic Prostatectomy Robot Open (LAPPRO)— a prospective, controlled, nonrandomized trial performed at 14 Swedish centers. Outcome measurements and statistical analysisData were collected at visits and by patient questionnaires at 3, 12, and 24 mo, and through a structured telephone interview at 6 yr. Cause of death was retrieved from the National Cause of Death Register in Sweden. The modified Poisson regression approach was used for analyses. Results and limitationsAfter adjustment for patient-, tumor-, and surgeon-related confounders, no statistically significant difference was observed between RALP and RRP in biochemical recurrence rate (14 vs 16%, relative risk [RR] 0.77, 95% confidence interval [CI] 0.56–1.06) or in not cured endpoint (22% vs 23%, RR 0.82, 95% CI 0.6–1.11). Stratified by D’Amico risk group, a significant benefit for RALP existed for recurrent disease in high-risk patients (RR 0.47, 95% CI 0.26–0.86, p=0.02). All-cause mortality was 3% (n=96). Prostate cancer–specific mortality was 0.6% (n=21) overall, 0.3% (n=8) after RALP, and 1.5% (n=13) after RRP. The nonrandomized design is a limitation. ConclusionsNo significant difference was observed for cancer recurrence rate between RALP and RRP 6 yr after surgery. However, in a subgroup analysis, we found a significant benefit for RALP regarding recurrence rate in the high-risk group. Larger studies with longer follow-up are needed to make a firm conclusion and to evaluate a possible survival benefit. Patient summaryIn general, the oncological outcome is comparable between robotic and open radical prostatectomy 6 yr after surgery. For high-risk patients, our findings indicate that there is an advantage for robotics, but further studies with longer follow-up time is needed to make a firm conclusion.

PT287 - Comparison of cognitive function after robot-assisted prostatectomy and open retropubic radical prostatectomy: A prospective observational single-center study

PT287 - Comparison of cognitive function after robot-assisted prostatectomy and open retropubic radical prostatectomy: A prospective observational single-center study

PT288 - Post-anesthesia care unit delirium following robot-assisted versus open retropubic radical prostatectomy – a prospective observational study

PT288 - Post-anesthesia care unit delirium following robot-assisted versus open retropubic radical prostatectomy – a prospective observational study

PT038 - Fascial anastomosis suspension technique (FAST) during open retropubic radical prostatectomy: A novel method to improve early postoperative recovery of urinary continence

PT038 - Fascial anastomosis suspension technique (FAST) during open retropubic radical prostatectomy: A novel method to improve early postoperative recovery of urinary continence

Опыт ведения пациентов с разрывом уретроцистоанастомоза после радикальной позадилонной простатэктомии (клинический случай)

Опыт ведения пациентов с разрывом уретроцистоанастомоза после радикальной позадилонной простатэктомии (клинический случай)

Differences in risk factors for biochemical recurrence after radical prostatectomy stratified by the degree of obesity: Focused on surgical methods

This study aims to evaluate differences in the risk factors for biochemical recurrence (BCR) for radical prostatectomy stratified by degree of obesity, focusing on the surgical method used. All 3099 patients who underwent radical prostatectomy in two medical centres from January 2008 to March 2018 were retrospectively reviewed. Patients were divided into three groups based on body mass index: ‘normal’, ‘overweight’, and ‘obese’. Risk factors associated with biochemical recurrence were compared between different degrees of obesity. We analysed the contributing risk factors of BCR-free survival using univariate and multivariable Cox hazard models. There were 378 (12.2%) and 1815 (58.6%) patients in the ‘obese’ and ‘overweight’ groups, respectively. Accordingly, 1324 patients underwent retropubic radical prostatectomy (RRP), and 1775 underwent robotic-assisted laparoscopic prostatectomy (RALP). Multivariable analysis showed that patients who underwent RALP had significantly lower BCR free survival in the ‘overweight’ and ‘obese’ groups than those who underwent RRP, with adjusted hazard ratios of 0.75 (95% CI 0.59–0.95, p-value = 0.01) and 0.55 (95% CI 0.33–0.90, p-value = 0.02), respectively. The degree of obesity was not directly associated with BCR-free survival. Robotic prostatectomy showed greater benefits in BCR-free survival than open prostatectomy in the ‘overweight’ and ‘obese’ groups.

Comparing the effect of positioning on cerebral autoregulation during radical prostatectomy: a prospective observational study

PurposeSurgery in the prolonged extreme Trendelenburg position may lead to elevated intracranial pressure and compromise cerebral hemodynamic regulation. We hypothesized that robot-assisted radical prostatectomy with head-down tilt causes impairment of cerebral autoregulation compared with open retropubic radical prostatectomy in the supine position.MethodsPatients scheduled for elective radical prostatectomy were included at a tertiary care prostate cancer clinic. Continuous monitoring of the cerebral autoregulation was performed using the correlation method. Based on measurements of cerebral oxygenation with near-infrared spectroscopy and invasive mean arterial blood pressure (MAP), a moving correlation coefficient was calculated to obtain the cerebral oxygenation index as an indicator of cerebral autoregulation. Cerebral autoregulation was measured continuously from induction until recovery from anesthesia.ResultsThere was no significant difference in cerebral autoregulation between robot-assisted and open retropubic radical prostatectomy during induction (p = 0.089), intraoperatively (p = 0.162), and during recovery from anesthesia (p = 0.620). Age (B = 0.311 [95% CI 0.039; 0.583], p = 0.025) and a higher difference between baseline MAP and intraoperative MAP (B = 0.200 [95% CI 0.073; 0.327], p = 0.002) were associated with impaired cerebral autoregulation, whereas surgical technique was not (B = 3.339 [95% CI 1.275; 7.952], p = 0.155).ConclusionCompared with open radical prostatectomy in the supine position, robot-assisted surgery in the extreme Trendelenburg position with capnoperitoneum did not lead to an impairment of cerebral autoregulation during the perioperative period in our study population.Trial registration number: DRKS00010014, date of registration: 21.03.2016, retrospectively registered.

Guiding Opioid Administration by 3 Different Analgesia Nociception Monitoring Indices During General Anesthesia Alters Intraoperative Sufentanil Consumption and Stress Hormone Release: A Randomized Controlled Pilot Study.

This pilot study investigated the effect of sufentanil titration by 3 different analgesia monitoring devices or clinical signs during general anesthesia. Forty-eight patients undergoing radical retropubic prostatectomy with sevoflurane/sufentanil anesthesia were randomly assigned into 4 groups and received sufentanil guided either by 1 of 3 analgesia monitoring devices (Surgical Pleth Index [SPI], Pupillary Pain Index [PPI], Nociception Level [NoL]) or by clinical judgment (control). The primary end point was intraoperative sufentanil consumption. Adrenocorticotropic hormone (ACTH) and cortisol were measured at 4 time points during the day of surgery. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests and by mixed model and area under the curve (AUC) analyses for group comparisons and time effects of stress hormones. The total amount of sufentanil administration (μg·kg·minute·10) differed between the groups (median [quartiles]: control = 5.6 [4.4-6.4], SPI = 7.2 [4.8-8.4], PPI = 2.0 [1.8-2.9], NoL = 3.8 [3.3-5.1]; PPI versus SPI, -5.1 [-6.6 to -1.3], P < .001; NoL versus SPI, -3.0 [-5.2 to 0.2], P = .024; control versus SPI, -1.6 [-3.7 to 1.7], P = .128; NoL versus PPI, 1.7 [0.6-3.4], P < .001; control versus PPI, 3.4 [2.0-4.6], P < .001; control versus NoL, 1.6 [-0.2 to 3.3], P = .017) (Hodges-Lehmann estimator [99% confidence interval {CI}], P values). The AUC analysis indicated differences among groups in cumulative ACTH levels (ng·liter·minute, natural logarithm (ln)-transformed data) of NoL versus PPI (-1.079 [-1.950 to -0.208], P = .001) and PPI versus SPI (1.192 [0.317-2.068], P= .001), as well as differences in cortisol levels (µg·liter·minute) for PPI versus SPI (46,710 [21,145-72,274], P < .001), NoL versus SPI (27,645 [3163-52,126], P = .003), and control versus SPI (31,824 [6974-56,675], P = .001) (differences in means [99% CI], P value). Secondary end points (postoperative recovery, pain level, and analgesia medication) showed no differences. The type of analgesia nociception monitoring affected the total amount of sufentanil administered. Lower sufentanil doses in the PPI group were associated with an increased endocrine stress response. Titration by SPI caused no opioid reduction compared to the control but was associated with a reduced endocrine stress response.

Initial Experiences of Retropubic Radical Prostatectomy Including Antegrade Nerve Sparing, Continuous Anastomosis, and Preservation of Endopelvic Fascia

Initial Experiences of Retropubic Radical Prostatectomy Including Antegrade Nerve Sparing, Continuous Anastomosis, and Preservation of Endopelvic Fascia

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial

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.

The inflammation-related biomarker CXCR7 independently predicts patient outcome after radical prostatectomy

IntroductionThe influence of inflammation on prostate tumor carcinogenesis is currently much better known than with its role in prostate cancer (CaP) progression. We evaluated the prognostic value of epigenetic (HDAC1, HDAC4, H3Ac) and inflammation-related (CXCR4, CXCR7, CXCL12) biomarkers immunoexpression, in radical prostatectomy specimens, from 2 cohorts of CaP patients with long term follow-up. Materials and MethodsFormalin-fixed and paraffin-embedded radical prostatectomy specimens were obtained from the pathology archives of Prof. Doutor Fernando Fonseca Hospital, in Amadora, Portugal and Portuguese Oncology Institute of Porto, in Porto, Portugal, and tissue microarrays were assembled. It was achieved a set of 234 patients submitted to radical retropubic prostatectomy between January 2000 and December 2005. Immunohistochemistry was used for evaluation of protein expression of epigenetic and inflammation-related markers. Nuclear staining was assessed using digital image analysis. Study outcomes included disease-specific survival and disease-free survival (DFS). Statistical analysis was tabulated using SPSS version 23.0. Hazard ratios (HRs) and survival curves were estimated using Cox-regression and Kaplan-Meyer models, respectively. Statistical significance was set at P < 0.05. ResultsComplete follow-up data was available for 234 patients and median follow-up time was 164 [11–218] months. Patients with higher CXCR4 immunoexpression experienced significantly worse disease-specific survival compared to patients with low expression (HR = 1.016, 95% CI: 1.002–1.031). The same happened with CXCL12 (HR = 0.546 95% CI: 0.322–0.926) and H3Ac (HR = 1.015, 95% CI: 1.001c1.029). In what concerns to DFS, patients with higher expression of CXCR4 and CXCR7 were significantly more prone to experience disease recurrence (HR = 1.003, 95% CI: 1.000–1.005 and HR = 1.111, 95% CI:1.032–1.196, respectively). When adjusted to pTStage and WHO Grade Groups, CXCR7 maintained independent impact on DFS (HR = 1.119, 95% CI: 1.032–1.214). ConclusionsThe interplay between inflammation and epigenetics and its impact in CaP outcome deserves further studies in the future. CXCR7 shows an independent predictor for worse DFS after radical prostatectomy, and could provide important prognostic information for patient management after radical prostatectomy.

MP74-06 90-DAY CAUSE-SPECIFIC MORTALITY AFTER RADICAL PROSTATECTOMY. NATIONWIDE POPULATION-BASED SWEDISH REGISTRY STUDY

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV (MP74)1 Apr 2020MP74-06 90-DAY CAUSE-SPECIFIC MORTALITY AFTER RADICAL PROSTATECTOMY. NATIONWIDE POPULATION-BASED SWEDISH REGISTRY STUDY Johan Björklund*, Pär Stattin, Markus Aly, and Olof Akre Johan Björklund*Johan Björklund* More articles by this author , Pär StattinPär Stattin More articles by this author , Markus AlyMarkus Aly More articles by this author , and Olof AkreOlof Akre More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000960.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In a previous study we found that 90-day mortality after radical prostatectomy (RP) was low (39/22 344, 0.17%). However, one third of patients who died within 90 days died of prostate cancer according to Cause of Death Registry (CDR). It is unlikely that a patient would die with a disseminated prostate cancer (PC) within 90-days of curative surgery. To investigate this we conducted a validation study. METHODS: Through the National Prostate Cancer Register of Sweden (NPCR), we identified all men registered undergoing radical prostatectomy (RP) between 1st of Jan 1998 – 30th of June 2018 and died within 90 days after RP. Medical records from the surgery and from the time of death as well as autopsy reports were obtained. The information provided from the NPCR was compared with the data collected via the medical records. RESULTS: In NPCR, 45 148 patients were registered with a RP within the study period. 58 patients met the final criteria of death within 90 days of a RP, with a 90-day all-cause mortality rate of 0.13%. 16 (28%) patients died of PC according to CDR, however no patient had metastatic disease documented in their chart. The most common causes of death within 90 days in the chart review was heart disease (28%) and venous thromboembolic events (VTE) (19%). The 90-day all-cause mortality was 0.09% for Robotically assisted laparoscopic radical prostatectomy (RARP), and 0.18% for Retropubic Radical Prostatectomy (RRP) OR 1.97 (95%CI 1.1-3.4, p=0.002). RARP were however more performed in the later part of the study period, represented by the median year of 90-day mortality after RP was 2006 for RRP and 2013 for RARP. The risk of a VTE-related death with in 90 days was twice as high after RRP compared to RARP. CONCLUSIONS: This study shows that there is ascertainment bias in the CDR since it is unlikely that a man would die of PC within 90-days after RP when no metastasis has been documented. The study show differences in rates and in type of mortality between RRP and RARP, however, due to the differences in time when the different surgeries were performed there are substantial risks of bias influencing these findings. The most common cause of death within 90-days of RP was related to cardiac diseases. Source of Funding: Stockholm County Council © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1133-e1134 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johan Björklund* More articles by this author Pär Stattin More articles by this author Markus Aly More articles by this author Olof Akre More articles by this author Expand All Advertisement PDF downloadLoading ...

PD22-03 RADICAL PROSTATECTOMY IN RENAL TRANSPLANT RECIPIENTS A COMPARATIVE STUDY WITH A PAIRED NON TRANSPLANTED GROUP: SURGICAL AND LONG TERM ONCOLOGICAL OUTCOMES

INTRODUCTION AND OBJECTIVE:The aim of this study is to present the experience from a tertiary center on radical retropubic prostatectomy in renal transplant recipients (RTR) and compare surgical an...

Postanesthesia care unit delirium following robot-assisted vs open retropubic radical prostatectomy: A prospective observational study.

The aim of this study was to compare the incidence of early postoperative delirium in the postanesthesia care unit (PACU) between robot-assisted radical prostatectomy (RARP) in the extreme Trendelenburg position and open retropubic radical prostatectomy (ORP) in supine position. Patients were screened for delirium signs 15, 30, 45, and 60 minutes following extubation. PACU delirium was present in 39.3% of RARP (64/163) patients and 41.8% of ORP (77/184) patients. Higher age (OR 1.072, 95%CI: 1.034-1.111, P < .001), total intravenous anesthesia (OR 2.001, 95%CI: 1.243-3.221, P = .004), and anesthesia duration (OR 1.255, 95%CI: 1.067-1.476, P = .006) were associated with PACU delirium, but no association was found between surgical technique and PACU delirium. Compared with inhalational anesthesia, total intravenous anesthesia using propofol-sufentanil, higher age, and longer duration of anesthesia were associated with PACU delirium. Based on these findings, adverse effects on postoperative recovery and delirium signs do not have to be considered in the choice of surgical approach for radical prostatectomy. https://www.drks.de/, identifier: DRKS00010014.

Long-term health-related quality-of-life outcomes in a racially diverse cohort of prostate cancer patients receiving retropubic versus robotic prostatectomy.

37 Background: This study compared 5-year health-related quality of life (HRQoL) outcomes among prostate cancer (PCa) patients who underwent a robotic-assisted radical prostatectomy (RARP) versus a radical retropubic prostatectomy (RRP), with a focus on race-specific outcomes for Caucasian American (CA) compared to African American (AA) men. RARPs have almost replaced RRPs in recent years, with few long-term studies focused on HRQoL and race. Methods: A prospective cohort study of HRQoL was conducted on patients diagnosed with PCa from 2007 to 2017 and enrolled in the Center for Prostate Disease Research (CPDR) Multicenter National Database. HRQoL was assessed with the EPIC instrument. Temporal changes in urinary and sexual-related quality of life domain scores were compared across surgery type (RARP versus RRP) at pre-treatment (“baseline”), 1-, 2-, 3-, 4-, and 5 years post-baseline. Longitudinal HRQoL patterns were modeled using generalized estimating equations (GEE), adjusting for baseline HRQoL and key clinical characteristics. Results: Of 497 PCa patients who met study inclusion criteria, 68% had RARP and 32% had RRP, with 22% AA men and 88% CA men. Baseline HRQoL domains were comparable across race and surgery type. In adjusted GEE analysis, no differences were noted between AA and CA patients. However, treatment-related differences were observed over time in urinary function (UF) and incontinence (UI) (p=0.02 and p=0.03, respectively), with lower HRQoL scores in RARP vs. RRP patients. Upon dual stratification by surgery type and race, the differences for UF and UI persisted (p=0.01 and p=0.03, respectively) with poorest outcomes observed, and similar trajectories of decline, for AA patients who received RARP. Conclusions: In this 10+ year prospective cohort study, AA patients receiving RARP had the poorest UF and UI outcomes which continued to decline for 5 years post treatment. In light of these findings, AA men considering RARP might benefit from discussions with their providers to set expectations regarding long-term urinary outcomes; though these decrements in HRQoL may be overshadowed by the minimally invasive nature of RARP.

Comparison of Cognitive Function After Robot-Assisted Prostatectomy and Open Retropubic Radical Prostatectomy: A Prospective Observational Single-Center Study

To assess the effects of robot-assisted radical prostatectomy in the Trendelenburg position on postoperative neurocognitive outcomes this study compared cognitive function between patients who underwent robot-assisted radical prostatectomy and those who underwent open retropubic radical prostatectomy. Objective evaluations of pre- and postoperative cognitive function were performed upon admission and before hospital discharge, by using a neuropsychological test battery. We collected self-reported data on cognitive failures at 3 months postoperatively. Binary logistic regression analysis was used to assess the effects of surgical technique on postoperative cognitive performance. The pre- and postoperative neuropsychological assessments were completed by 367 patients with a median age of 64 years (range 44-76). The incidence of postoperative cognitive dysfunction was 23.9% after robot-assisted (39/165) and 22.3% after open radical prostatectomy (45/202). There was no significant difference in postoperative cognitive function during the early postoperative period (P = 0.758) and self-reported cognitive failures at 3 months (P = 0.303) between robot-assisted and open surgery. Surgical technique was not associated with early postoperative cognitive dysfunction in multivariable analysis (OR 1.012, 95%CI: 0.608-1.685, P = 0.962). Compared with open surgery in supine position postoperative neurocognitive disorders do not occur more frequently after robot-assisted radical prostatectomy in the extreme Trendelenburg position. Based on these findings potential adverse effects on cognitive function do not have to be considered in the choice of surgical approach for radical prostatectomy.

Analysis of Correlation and Agreement between the Uroflowmetry and the International Prostate Symptom Score in Patients after retropubic Radical Prostatectomy: A Multicenter Prospective Study

Abstract Objectives Patients undergoing retropubic radical prostatectomy (RRP) may suffer from lower urinary tract symptoms (LUTS). We aim to characterize LUTS and to evaluate the correlation and agreement between uroflowmetry and the International Prostate Symptom Score (IPSS) in patients after RRP in two reference centers. Methods An observational multicenter prospective study was conducted between December 2015 and September 2016. Patients with at least 12-months of follow-up after RRP were included; these were evaluated with uroflowmetry and the IPSS. Results A total of 90 patients were included. The mean follow-up was of 54.6 months (standard deviation [SD] = 27.52), and the mean age was 65 (SD = 6.85) years old. The mean IPSS was 7.41 (SD = 6.29), with 33.3% (n = 54) of the patients with moderate symptoms and 6.7% (n = 6) with severe symptoms. A total of 50% (n = 45) of the patients had normal uroflowmetry. Patients with an abnormal/equivocal result in the uroflowmetry had a mean of 9.31 (SD = 7.03) points in the IPSS versus 5.51 (SD = 4.82) in patients with a normal uroflowmetry result (p &lt; 0.01). The level of agreement between mild versus moderate-to-severe LUTS and normal uroflowmetry versus abnormal/equivocal was 61.1% (k = 0.22, p = 0.04). We found that a score ≥ 10 in the IPSS had a level of agreement of 65.6% (k = 0.31, p = 0.0004). Conclusions We consider that although the IPSS cannot replace uroflowmetry and vice versa, these tests are complementary and may be useful tools in the evaluation of patients with LUTS after RRP.

Long term outcomes of retropubic radical prostatectomy and their prognostication

Long term outcomes of retropubic radical prostatectomy and their prognostication

Radical retropubic prostatectomy patients' quality of life analysis within the first year after the surgery

Radical retropubic prostatectomy patients' quality of life analysis within the first year after the surgery

Evaluation of the Results and Complications of Transabdominal Preperitoneal Laparoscopic Inguinal Hernia Repair in Patients with a History of Radical Prostatectomy.

Radical prostatectomy is one of the most common urological surgeries. Inguinal hernia is a well-known complication of radical prostatectomy. There are many controversies about selection of surgical techniques for repair of inguinal hernia. Traditionally laparoscopic approach was contraindicated for patients with history of lower abdominal surgery, but recent studies showed that it could be safe and successful and even has some advantages over open repair. In this prospective study we evaluated outcomes of laparoscopic hernia repair in patients who previously underwent radical prostatectomy. In this prospective study, 34 consecutive patients diagnosed with inguinal hernia after radical retropubic prostatectomy underwent laparoscopic transabdominal inguinal repair and followed up for outcomes and complications. The surgery duration was 167.44 ± 52.85 min (75-230 min). No intraoperative complications occurred. Patients were discharged within 20.79 ± 4.76 hours (12-34 hours). 69.8% of cases (30 patients) needed analgesic administration. No conversion to open surgery occurred. There were 9.3% (4 hernias) hernia recurrences. We followed patients for 9.9 ± 5.33 months (2-19 months). It is concluded that TAPP for inguinal hernia repair after radical prostatectomy has good results and is effective. But according to rate of recurrence, its safeness is conflicting. We notice no major complication in our patients during the time of follow up. This may be due to safety of the operation in the proposed patients.