Inguinal hernia after radical prostatectomy: is it different in the minimally invasive era?

Abstract

With an increasing incidence of prostate cancer in the UK, the number of radical prostatectomies carried out is also increasing. In 2014, 13% of men diagnosed with prostate cancer had a radical prostatectomy. Almost half of those were carried out with a robotic assisted approach; the remainder were performed by open surgery, conventional laparoscopy or transperineal prostatectomy. Inguinal hernia post radical prostatectomy is rarely discussed during the consent process but the incidence is estimated to be between 15% and 20%. There is a number of theories as to why this might occur including a weakness in the myopectineal orifice and as a result of opening the endopelvic fascia. In this article we aim to review the evidence for the development of inguinal herniae post radical prostatectomy and to assess whether the advent of minimally invasive surgery has altered this process.