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The processus vaginalis transection method is superior to the simple prophylactic procedure for prevention of inguinal hernia after radical prostatectomy

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Abstract

Background

We compared retrospectively the efficacy of two methods for prevention of post-radical prostatectomy inguinal hernia: blunt dissection of the peritoneum at the internal inguinal ring, and isolation of the spermatic cord from the peritoneum (simple prophylactic procedure) and transection of the processus vaginalis.

Methods

Of the 367 patients who underwent open radical retropubic prostatectomy for clinically localized prostate cancer between February 2005 and March 2012 at Saitama Cancer Center Hospital, 344 patients whose follow-up period was more than 2 years were enrolled in this study. Of these patients, 178 patients received the simple prophylactic procedure and 57 underwent processus vaginalis transection. We evaluated the risk factors for inguinal hernia (age; anastomotic stricture post radical prostatectomy; prophylactic procedures for inguinal hernia; previous history of abdominal surgery; previous inguinal hernia surgery; body mass index) using univariate and multivariate analysis. The effects of the two prophylactic procedures on incidence of inguinal hernia were analyzed using Kaplan–Meier plots.

Results

The incidence of inguinal hernia was 24.8 % in those not undergoing the prophylactic procedure; 18.5 % in those undergoing the simple prophylactic procedure; and 0.00 % in those undergoing the processus vaginalis transection procedure (p < 0.001). In univariate and multivariate analysis, undergoing the processus vaginalis transection procedure and high body mass index were significant predictors for hernia-free survival after radical prostatectomy.

Conclusion

Our data suggest that the processus vaginalis transection procedure is superior to the simple prophylactic procedure for the prevention of inguinal hernia after radical prostatectomy.

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Authors and Affiliations

  1. Department of Urology, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi gun, Saitama, 362-0806, Japan

    Toshihiro Kanda, Syohei Fukuda, Naotaka Fukui & Yukio Kageyama

  2. Department of Urology, JA Toride Medical Center, Hongo 2-1-1, Toride, Ibaraki, 302-0022, Japan

    Yusuke Kohno

Authors
  1. Toshihiro Kanda
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  2. Syohei Fukuda
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  3. Yusuke Kohno
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  4. Naotaka Fukui
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  5. Yukio Kageyama
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Corresponding author

Correspondence to Toshihiro Kanda.

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The authors declare that they have no conflict of interest.

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Kanda, T., Fukuda, S., Kohno, Y. et al. The processus vaginalis transection method is superior to the simple prophylactic procedure for prevention of inguinal hernia after radical prostatectomy. Int J Clin Oncol 21, 384–388 (2016). https://doi.org/10.1007/s10147-015-0881-9

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  • DOI: https://doi.org/10.1007/s10147-015-0881-9

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