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Patent processus vaginalis in adults who underwent robot-assisted laparoscopic radical prostatectomy: Predictive signs of postoperative inguinal hernia in the internal inguinal floor

 Dong Hoon Lee  ;  Ha Bum Jung  ;  Mun Su Chung  ;  Seung Hwan Lee  ;  Byung Ha Chung 
 INTERNATIONAL JOURNAL OF UROLOGY, Vol.20(2) : 177-182, 2013 
Journal Title
Issue Date
Age Distribution ; Aged ; Analysis of Variance ; Cohort Studies ; Follow-Up Studies ; Hernia, Inguinal/diagnosis* ; Hernia, Inguinal/epidemiology ; Hernia, Inguinal/etiology ; Humans ; Incidence ; Inguinal Canal/abnormalities* ; Kaplan-Meier Estimate ; Laparoscopy/adverse effects* ; Laparoscopy/methods ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Predictive Value of Tests ; Proportional Hazards Models ; Prostatectomy/adverse effects* ; Prostatectomy/methods ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery* ; Retrospective Studies ; Risk Assessment ; Robotics/methods* ; Statistics, Nonparametric
adult ; inguinal hernia ; patent processus vaginalis ; prostatectomy
OBJECTIVE: To evaluate the risk for postoperative inguinal hernia according to the presence of patent processus vaginalis in an adult population. METHODS: Medical records of 205 patients who underwent robot-assisted laparoscopic radical prostatectomy from May 2007 to November 2011 were reviewed. Age, prostate-specific antigen, prostate volume, body mass index, operative time and history of previous abdominal surgery were evaluated. The existence of patent processus vaginalis was also evaluated for the development of postoperative inguinal hernia. RESULTS: Postoperative inguinal hernia occurred in 20 out of 410 (4.9%) groins (17/205 patients; 8.3%), and patent processus vaginalis was observed in 49 out of 410 (11.9%) groins. In the normal groin group, inguinal hernia occurred in seven out of 361 (1.9%) groins. However, in the patent processus vaginalis group, it occurred in 13 out of 49 (26.5%) groins. On univariate analysis using Cox proportional hazards model, age, body mass index, history of previous abdominal surgery and patent processus vaginalis were significant risk factors. Among them, patent processus vaginalis significantly increased the risk of postoperative inguinal hernia in multivariate analysis (hazard ratio 22.37). In the patent processus vaginalis group, inguinal hernia developed at 12.9 ± 9.2 months after robot-assisted laparoscopic radical prostatectomy and 15 ± 7.4 months in the normal groin group. Inguinal hernia-free ratios were significantly lower in the patent processus vaginalis group than the normal groin group (P<0.001). CONCLUSIONS: The existence of patent processus vaginalis represents an important risk factor for postoperative inguinal hernia in adults. Urologists should consider the possibility of postoperative inguinal hernia when patent processus vaginalis is observed during surgery.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Dong Hoon(이동훈)
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Jung, Ha Bum(정하범)
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