Inseparable interaction of the prostate and inguinal hernia

Int J Urol. 2018 Jul;25(7):644-648. doi: 10.1111/iju.13717. Epub 2018 Jun 19.

Abstract

With an increase in their prevalence, it has become apparent that both benign prostatic hyperplasia and radical prostatectomy for cancer can induce inguinal hernia development. An inguinal hernia is a common late complication following radical prostatectomy, with an occurrence rate of 12-25%. Following radical prostatectomy, the space of Retzius can develop adhesions to surrounding tissue, often causing difficulty during inguinal hernia repair. Conversely, inguinal hernia repair before radical prostatectomy also induces severe adhesions around the space of Retzius and causes difficulty during radical prostatectomy. The association between radical prostatectomy and inguinal hernia development is complex and unclear. Both urologists and surgeons are challenged by this interaction. The surgical approaches for prostate cancer have undergone a major transition from open surgery to robotic surgery, and the treatment of inguinal hernia is also changing. Based on historical trends, several preventive and treatment measures have been proposed, although there is no direct evidence for risk factors that lead to inguinal hernia development. This article focuses on the complex interaction between the prostate and inguinal hernia, and considers preventive measures against inguinal hernia development.

Keywords: inguinal hernia; prostate; surgery.

Publication types

  • Review

MeSH terms

  • Hernia, Inguinal / epidemiology*
  • Hernia, Inguinal / etiology
  • Hernia, Inguinal / prevention & control
  • Humans
  • Male
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Prostate / pathology
  • Prostate / surgery
  • Prostatectomy / adverse effects*
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / epidemiology
  • Prostatic Neoplasms / surgery*