Abdominal straining associated with voiding dysfunction or constipation has traditionally been associated with the development of abdominal wall hernias. Thus, classic general surgery dictum recommends that any coexistent bladder outlet obstruction should be addressed by the urologist before patients undergo surgical repair of a hernia. While organ-confined prostate cancer is usually not associated with the development of lower urinary tract symptoms, a modest proportion of patients treated with radical prostatectomy may have coexisting benign prostatic hyperplasia with elevated symptom scores and hernias may be incidentally detected at the time of surgery. Furthermore, dissection of the space of Retzius during retropubic or minimally invasive prostatectomy may result exposure of abdominal wall defects which may have been present, but asymptomatic if plugged with preperitoneal fat. Herein we examine the literature regarding the incidence of postoperative inguinal hernias after prostatectomy, review potential risk factors which could aid in preoperative patient identification, and discuss the published experience regarding concurrent hernia repair at the time of open or minimally invasive radical prostatectomy.
Current urology reports. 2017 Jun [Epub]
Francois G Soto-Palou, Ricardo F Sánchez-Ortiz
Robotic Urology and Oncology Institute and the Division of Urology, Department of Surgery, University of Puerto Rico School of Medicine, Suite 306, 400 F.D. Roosevelt Avenue, San Juan, PR, 00918, USA., Robotic Urology and Oncology Institute and the Division of Urology, Department of Surgery, University of Puerto Rico School of Medicine, The University of Texas MD Anderson Cancer Center, Suite 306, 400 F.D. Roosevelt Avenue, San Juan, PR, 00918, USA. .