Simultaneous Bilateral Anterior Inguinal Herniorrhaphy with Polypropylene Mesh Application and Open Prostatectomy

Abstract

Aims: Lower urinary tract symptoms (LUTS) are common in aging men. Benign prostatic hyperplasia (BPH) develops with advancing age. The incidence of inguinal hernia also increases with age. A significant number of elderly men with symptoms of BPH have inguinal hernia at the same time. Simultaneous preperitoneal inguinal hernia repair with other pelvic surgeries has been described, but it was not popular among urologists and general surgeons mainly because of high recurrence rate. Study Design: Prospective study. Place and Duration of Study: Department of Urology, Tabriz University of Medical Sciences, Imam Reza Hospital, between March 2010 and September 2013 Methodology: We evaluated the outcomes and complications of 37 patients who underwent open transvesical prostatectomy and simultaneous bilateral preperitoneal herniorrhaphy with application of polypropylene mesh. Results: Twelve patients with bilateral direct hernia, 24 patients with bilateral indirect hernia and one patient with right side direct and left side indirect inguinal hernia were enrolled in our study. Four patients (10.8%) had bilateral recurrent hernias and 2 others (5.4%) had recurrent hernia on one side and primary hernia on the other side. Mean operation time was 86 minutes (71-110). The mean blood loss during surgery was 578 (240-1250)ml. The median clinical follow-up time was 13.7 months. During follow-up period surgical site infection, hematoma, chronic pain and recurrence were not detected. One (2.7%) lymphocele formation was detected. In all patients, the surgical outcomes were satisfactory. Conclusion: Simultaneous prostatectomy and preperitoneal herniorrhaphy with mesh application, is a convenient and safe procedure which can be performed easily by urologists. This procedure is both cost effective and time-saving and achieves long term beneficial outcomes for patients.