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Inguinal Hernia Post RARP

lighterwood67's picture
lighterwood67
Posts: 202
Joined: Feb 2018

Well, may want to add one more to the long list of side effects of a RARP.  

Background

Robot-assisted radical prostatectomy (RARP) has now become a gold standard approach in radical prostatectomy. The aim of this study was to investigate incidence and risk factors of inguinal hernia (IH) after RARP.

Methods

This study included 307 consecutive men who underwent RARP for the treatment of prostate cancer from January 2011 to August 2015. The incidence of IH after RARP was investigated. Clinical and pathological factors were also investigated to assess relationship with development of postoperative IH.

Results

Median follow-ups were 380 days, and median age of patients was 67 years. Incidence of IH was 11.3, 14.0, and 15.4% at 1, 2, and 3 years after RARP, respectively. Postoperative IH occurrence was significantly associated with low surgeon experience and postoperative incontinence at 3 or 6 months after surgery (P = 0.019, P = 0.002, and P = 0.016, respectively).

Conclusions

Most of the IH occurred within the first 2 years with a rate of 14%. Incidence of IH after RARP was significantly associated with surgical experience and incontinence outcomes.

Keywords: Inguinal hernia, Prostate cancer, Radical prostatectomy, Robot-assisted radical prostatectomy
Georges Calvez
Posts: 243
Joined: Sep 2018

...get yourself a good surgeon and pin some lucky shamrock on your gown.
 Post operative incontinence, inguinal hernia, erectile dysfunction are all associated with inexperienced surgeons but you can still draw the short straw, hence the need for the shamrock, etc! :-)

lighterwood67's picture
lighterwood67
Posts: 202
Joined: Feb 2018

My surgeon was the Chief of Urology (Surgery and Onocology) at Levine Cancer Institute.  He has 2000+ RARP's.  I still do a good bit of lifting and stuff for my age, maybe that caused it.  My bet is that I should have worn the Shamrock. Sealed  Oh well, it is what is, going for my second opinion in about a week or so.  

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3274
Joined: May 2012

I also had DaVinci, and also had to have a hernia repair.  However, about two years prior to the RP I had my gallbladder removed, and I noted afterward that the incision points between the two surgeries were virtually identical; they overlapped.  Hence, I feel that two surgeries through the same spot likely weakened the tissue more than one would.

I wonder if waist size is not also very relevant in this.  It would be interesting to know if it was considered.   I needed to lose a few inches then, and now.

max

lighterwood67's picture
lighterwood67
Posts: 202
Joined: Feb 2018

My waist size is around 34".  I weigh around 172lbs.  I have been running these numbers for a couple of years. I think it just happens.  It may or may not be related to the RARP.  I live on a lake. Sometimes I cut 4 to 5 acres of grass a week for my father-in-law (he is 91).  This year I have cut down 2 trees (over 30 ft high; cut into logs; and put on the burn pile).  I can lift 35 to 50 lb bags of seed; fertilizer; etc with no leakage, but maybe I strained a little too hard.  If it was due to strain, I would think it came from changing the tire on the camper, that was tough 100 ft lbs of torque.  I have always had a little pain (not constant) after surgery on the lower left side.  I told the surgeon about that; they checked me and just logged it to part of the healing process.  I noticed the hernia while I was in the shower (left side groin area not symmetrical with right).  They told me due to the pelvic surgery (pelvic lymph node dissection, the hernia repair would be open surgery, outpatient 45 minutes to an hour or so).  To me it is what is, my PSA is still undetectable;  I am fully continent (partner yoga is challenging to do with no leakage);  still running around 75% on the ED issue (no add-ons).  As far as Quality of Life, I have not slowed down.  So far I see these issues as just bumps in the road.  I am fine.  I will get this fixed and see what else life has to throw at me.  Thanks for the comments.  It makes me feel like I am part of the team.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3274
Joined: May 2012

My herniation occured above the navel, where the incision to pull out the gland is.  I have never had herniation symptoms down in the genitial area.   Interesting fact:  the gall bladder, when removed with lapro surgery, is pulled out through the navel itself; this reduces visible scarring later.  So my two main incision points were within an inch of each other.  The worst part about surgery is the stretching, not the cutting, so I do believe my hernia was in part due to the gall bladder proceedure.

My hernia repair was laparoscopic also, and believe it or not, it too used the exact same access points, so I now have five incision points that have been cut through three times.  The surgeon said the mesh was about 6x6, or near the size of a wash cloth.

Like you, I focus on the big picture, and the cure of cancer was the most important outcome.  I do not blame anyone or any thing for my conditions.  And I too am constantly outside working in the yard or whatever, doing stuff I most likely shouldn't.  Working on the lawn, and thankful to be above ground.

max

Georges Calvez
Posts: 243
Joined: Sep 2018

Hi there,

I had a laparoscopic prostatectomy and the poke points on either side where the camera and instruments went in have now disappeared completely.
I am left with a scar of about an inch and a half, 4 cm, below the navel where the gland came out.
I had a BMI of about 25 going into surgery with low abdominal and visceral fat according to the surgeon.
Luckily for me I escaped having a drain shoved in.

Best wishes,

Georges

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