Patients with inguinal hernia (IH) may have voiding dysfunction and weak urethra-stabilizing periurethral fascial tissues, contributing to urinary incontinence. This study aimed to review the association between IH and urinary continence after robotic-assisted radical prostatectomy (RARP).
This single-institution retrospective study included 251 consecutive cases of RARP between April 2019 and June 2022. Patients with concurrent IH or a history of adult IH repair were examined. The urine loss rate (ULR), defined as 24-h urine loss volume divided by the total urine volume immediately after urinary catheter removal (i.e., 6 or 7 postoperative days), was compared between the groups with (n = 33) and without IH (n = 214). Possible contributing factors for ULR were assessed, including age, body mass index (BMI), after benign prostatic hyperplasia surgery, prostate weight, and nerve-sparing. ULR was compared intergroup after propensity score matching countering selection biases.
Patients with IH were older (71.3 versus. 66.8 years, p < 0.01), had lower BMI (22.8 versus. 24.3, p < 0.01), and had higher ULR (14.5% versus. 5.1%, p < 0.01). In a multiple linear regression analysis (adjusted R2 = 0.084), IH (p < 0.01) was an independent contributing factor for ULR besides advancing age (p < 0.03). After propensity score matching adjusted for patient's age and nerve-sparing, patients with IH had higher ULR (14.1% versus. 5.7%, p < 0.03) as well.
This study first reported that IH may be one of the risk factors of urinary incontinence after RARP.
Journal of robotic surgery. 2024 Jan 13*** epublish ***
Yu Ozawa, Keisuke Aoki, Shin Koike, Shu Gozu, Takaaki Yokoyama, Masumi Yamada, Yu Odagaki, Yuko Hisatome, Hideo Sakamoto, Kunihiko Yoshioka
Department of Urology, Itabashi Chuo Medical Center, 2-12-7 Azusawa, Itabashi, Tokyo, 174-0051, Japan. ., Department of Urology, Itabashi Chuo Medical Center, 2-12-7 Azusawa, Itabashi, Tokyo, 174-0051, Japan.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38217741