Concurrent radical retropubic prostatectomy and inguinal hernia repair through a modified Pfannenstiel incision

Murugesan Manoharan, P. Gomez, M. S. Soloway

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: To describe a technique for concurrent radical retropubic prostatectomy (RRP) and inguinal hernioplasty, using a modified Pfannenstiel incision. PATIENTS AND METHODS: RRP is usually done through a midline lower abdominal incision but some patients with localized prostate cancer have an inguinal hernia. Concurrent inguinal hernia repair at the time of RRP with the usual method is only possible by either a preperitoneal mesh repair or formal hernioplastv, requiring an additional incision(s). A 10-12 cm Pfannenstiel incision is made along the pubic hairline centred over the pubic symphysis, and a 'Y'-shaped incision in the rectus sheath. The rectus muscle is split vertically along the midline, followed by RRP. After removing the prostate and completing the anastomosis, the surgeon identifies the inguinal canal along the inferior and lateral aspect of the transverse incision and uses a formal tension-free hernioplasly with a 3 x 5 cm polypropylene mesh. We used this technique in fifteen concurrent inguinal hernioplasties (two bilateral hernias and thirteen unilateral) at the time of RRP, with no additional incisions, using the formal tension-free Lichlenslein technique. One patient with bilateral hernias had a right indirect inguinal hernia, and all the remaining men had a direct inguinal hernia. RESULTS: All patients were discharged 2 days after surgery, with no complications associated with the procedure and no recurrences; however, the follow-up was short (mean 5.5 months). CONCLUSION: A modified Pfannenstiel incision is ideal for concurrent RRP and inguinal hernioplasty, providing excellent exposure of the pelvic structures and allowing the surgeon to use a formal tension-free mesh hernioplasty through the same incision. Wound healing and cosmetic results are excellent.

Original languageEnglish
Pages (from-to)1203-1206
Number of pages4
JournalBJU International
Volume93
Issue number9
DOIs
StatePublished - Jun 1 2004

Fingerprint

Inguinal Hernia
Herniorrhaphy
Prostatectomy
Groin
Hernia
Pubic Symphysis
Inguinal Canal
Polypropylenes
Ambulatory Surgical Procedures
Cosmetics
Wound Healing
Prostate
Prostatic Neoplasms
Recurrence
Muscles

Keywords

  • Hernia
  • Inguinal
  • Pfannenstiel incision
  • Prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Concurrent radical retropubic prostatectomy and inguinal hernia repair through a modified Pfannenstiel incision. / Manoharan, Murugesan; Gomez, P.; Soloway, M. S.

In: BJU International, Vol. 93, No. 9, 01.06.2004, p. 1203-1206.

Research output: Contribution to journalArticle

Manoharan, Murugesan ; Gomez, P. ; Soloway, M. S. / Concurrent radical retropubic prostatectomy and inguinal hernia repair through a modified Pfannenstiel incision. In: BJU International. 2004 ; Vol. 93, No. 9. pp. 1203-1206.
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abstract = "OBJECTIVE: To describe a technique for concurrent radical retropubic prostatectomy (RRP) and inguinal hernioplasty, using a modified Pfannenstiel incision. PATIENTS AND METHODS: RRP is usually done through a midline lower abdominal incision but some patients with localized prostate cancer have an inguinal hernia. Concurrent inguinal hernia repair at the time of RRP with the usual method is only possible by either a preperitoneal mesh repair or formal hernioplastv, requiring an additional incision(s). A 10-12 cm Pfannenstiel incision is made along the pubic hairline centred over the pubic symphysis, and a 'Y'-shaped incision in the rectus sheath. The rectus muscle is split vertically along the midline, followed by RRP. After removing the prostate and completing the anastomosis, the surgeon identifies the inguinal canal along the inferior and lateral aspect of the transverse incision and uses a formal tension-free hernioplasly with a 3 x 5 cm polypropylene mesh. We used this technique in fifteen concurrent inguinal hernioplasties (two bilateral hernias and thirteen unilateral) at the time of RRP, with no additional incisions, using the formal tension-free Lichlenslein technique. One patient with bilateral hernias had a right indirect inguinal hernia, and all the remaining men had a direct inguinal hernia. RESULTS: All patients were discharged 2 days after surgery, with no complications associated with the procedure and no recurrences; however, the follow-up was short (mean 5.5 months). CONCLUSION: A modified Pfannenstiel incision is ideal for concurrent RRP and inguinal hernioplasty, providing excellent exposure of the pelvic structures and allowing the surgeon to use a formal tension-free mesh hernioplasty through the same incision. Wound healing and cosmetic results are excellent.",
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