Concurrent Hernia Repair with Gynecologic or Urologic Surgery? Pros and Cons

  • Michael ChoiEmail author
  • Cheguevara Afaneh


The feasibility and safety of concurrent hernia repair with gynecologic and urologic surgery have been well-described in the literature over the past six decades using a variety of approaches including open, laparoscopic, and robotic. Simultaneous inguinal herniorrhaphy performed at the time of prostatectomy and Cesarean section are the two most commonly performed concurrent procedures in the United States today. In this chapter, the benefits of concurrent hernia repair at the time of gynecologic/urologic surgery as well as the potential complications including wound/mesh infection rates, hernia recurrence, and postoperative pain will be discussed in detail. Finally, our technique for concurrent herniorrhaphy at the time of gynecologic/urologic procedures will also be described.


Concurrent hernia repair Urologic surgery Herniorrhaphy Preperitoneal herniorrhaphy Gynecologic surgery 


  1. 1.
    Kjærgaard J, Bay-Nielsen M, Kehlet H. Mortality following emergency groin hernia surgery in Denmark. Hernia. 2010;14(4):351–5.CrossRefGoogle Scholar
  2. 2.
    Antunes AA, et al. Inguinal hernia repair with polypropylene mesh during radical retropubic prostatectomy: an easy and practical approach. BJU Int. 2005;96(3):330–3.CrossRefGoogle Scholar
  3. 3.
    Abi-Haidar Y, Sanchez V, Itani KM. Risk factors and outcomes of acute versus elective groin hernia surgery. J Am Coll Surg. 2011;213(3):363–9.CrossRefGoogle Scholar
  4. 4.
    McDonald DF, Huggins C. Simultaneous prostatectomy and inguinal herniorrhaphy. Surg Gynecol Obstet. 1949;89(5):621.PubMedGoogle Scholar
  5. 5.
    Annandale T. Case in which a reducible oblique and direct inguinal and femoral hernia existed on the same side and were successfully treated by operation. Edinb Med J. 1876;21:1087–91.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Riba LW, Mehn WH. Combined inguinal hernia repair and retropubic prostatectomy. Q Bull Northwestern University Med School. 1951;25(1):62.Google Scholar
  7. 7.
    Nyhus LM, Condon RE, Harkins HN. Clinical experiences with preperitoneal hernia repair for all types of hernia of the groin: with particular reference to the importance of transversalis fascia analogues. Am J Surg. 1960;100(2):234–44.CrossRefGoogle Scholar
  8. 8.
    Nyhus LM. Posterior hernia repair and prostatic operations. Arch Surg. 1972;104(1):17.CrossRefGoogle Scholar
  9. 9.
    Stoppa RE, Rives JL, Warlaumont CR, Palot JP, Verhaeghe PJ, Delattre JF. The use of Dacron in the repair of hernias of the groin. Surg Clin N Am. 1984;64(2):269–85.CrossRefGoogle Scholar
  10. 10.
    Liem MS, van der Graaf Y, van Steensel CJ, Boelhouwer RU, Clevers GJ, Meijer WS, Stassen LP, Vente JP, Weidema WF, Schrijvers AJ, van Vroonhoven TJ. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med. 1997;336(22):1541–7.CrossRefGoogle Scholar
  11. 11.
    Lee BC, Rodin DM, Shah KK, Dahl DM. Laparoscopic inguinal hernia repair during laparoscopic radical prostatectomy. BJU Int. 2007;99(3):637–9.CrossRefGoogle Scholar
  12. 12.
    Regan TC, Mordkin RM, Constantinople NL, Spence IJ, Dejter SW. Incidence of inguinal hernias following radical retropubic prostatectomy. Urology. 1996;47(4):536–7.CrossRefGoogle Scholar
  13. 13.
    Nielsen ME, Walsh PC. Systematic detection and repair of subclinical inguinal hernias at radical retropubic prostatectomy. Urology. 2005;66(5):1034–7.CrossRefGoogle Scholar
  14. 14.
    Schlegel PN, Walsh PC. Simultaneous preperitoneal hernia repair during radical pelvic surgery. J Urol. 1987;137(6):1180–3.CrossRefGoogle Scholar
  15. 15.
    Choi BB, Steckel J, Denoto G, Vaughan ED, Schlegel PN. Preperitoneal prosthetic mesh hernioplasty during radical retropubic prostatectomy. J Urol. 1999;161(3):840–3.CrossRefGoogle Scholar
  16. 16.
    Drachenberg DE, Bell DG. Preperitoneal mesh-plug herniorrhaphy during radical retropubic prostatectomy. Can J Urol. 2002;9(4):1602–6.PubMedGoogle Scholar
  17. 17.
    Stolzenburg JU, Rabenalt R, Dietel A, Do M, Pfeiffer H, Schwalbe S, Dorschner W. Hernia repair during endoscopic (laparoscopic) radical prostatectomy. J Laparoendosc Adv Surg Tech A. 2003;13(1):27–31.CrossRefGoogle Scholar
  18. 18.
    Finley DS, Rodriguez E, Ahlering TE. Combined inguinal hernia repair with prosthetic mesh during transperitoneal robot assisted laparoscopic radical prostatectomy: a 4-year experience. J Urol. 2007;178(4):1296–300.CrossRefGoogle Scholar
  19. 19.
    Kelly ME, Behrman SW, Deitch EA, Fabian TC. The safety and efficacy of prosthetic hernia repair in clean-contaminated and contaminated wounds/discussion. Am Surg. 2002;68(6):524–8.PubMedGoogle Scholar
  20. 20.
    Carbonell AM, Criss CN, Cobb WS, Novitsky YW, Rosen MJ. Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg. 2013;217(6):991–8.CrossRefGoogle Scholar
  21. 21.
    Gözen AS, Tokas T, Akin Y, Atis G, Hruza M, Rassweiler J. Pain after hernia repair with simultaneous extraperitoneal laparoscopic radical prostatectomy. J Endourol. 2014;28(9):1143–8.CrossRefGoogle Scholar
  22. 22.
    Kessler HJ. Hernias in pregnancy. In: HRK B, Graber EA, editors. Surgical disease in pregnancy. Philadelphia: WB Saunders; 1974. p. 161–8.Google Scholar
  23. 23.
    Altchek A, Rudick J. Preperitoneal herniorrhaphy: adjunct to cesarean section. Obstet Gynecol. 1987;70(3 Pt 2):470–1.PubMedGoogle Scholar
  24. 24.
    Ochsenbein-Kölble N, Demartines N, Ochsenbein-Imhof N, Zimmermann R. Cesarean section and simultaneous hernia repair. Arch Surg. 2004;139(8):893–5.CrossRefGoogle Scholar
  25. 25.
    Gabriele R, Conte M, Izzo L, Basso L. Cesarean section and hernia repair: simultaneous approach. J Obstet Gynaecol Res. 2010;36(5):944–9.CrossRefGoogle Scholar
  26. 26.
    Wadhwa A, Chowbey PK, Sharma A, Khullar R, Soni V, Baijal M. Combined procedures in laparoscopic surgery. Surg Laparosc Endosc Percutan Tech. 2003;13(6):382–6.CrossRefGoogle Scholar

Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2019

Authors and Affiliations

  1. 1.Department of SurgeryWeill Cornell Medical CollegeNew YorkUSA

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