Should hernioplasty be combined with surgery of the prostate

OBJECTIVE: In some patients consulting for a prostatic condition, inguinal hernia might be incidentally discovered during evaluation. The results achieved by simultaneous prostatectomy and hernia repair are presented. METHODS: 52 patients with hyperplasia of the prostate and inguinal hernia underwent treatment for both conditions during the same surgical procedure. Patient ages ranged from 56-88 years. All patients underwent suprapubic prostatectomy and hernia repair. RESULTS: 35 patients had indirect and 17 direct inguinal hernia; 13 were bilateral and 39 unilateral. The hernia had been present from one month of 22 years (mean 46 months). Symptoms related with prostate enlargement had been present from one month to 22 years (mean 40 months). Herniorrhaphy was performed through the inguinal incision in 13 cases, prostatectomy was performed through a midline incision in 50 cases, and the Pfannenstiel incision was utilized in two cases. Pathological analysis showed 49 cases had BPH and 3 had cancer of the prostate. Hernia repair was done using the Bassini procedure in 35 cases, 18 cases had a Mac Vay procedure, preperitoneal herniorrhaphy was performed in one case, and closure and ligation of the sac in 11 cases. There were 15 cases of recurrence (28.8%). CONCLUSIONS: In patients with BPH or prostatic cancer and inguinal hernia, prostatectomy and herniorrhaphy can be performed during the same session without increasing patient morbidity and mortality. Urological surgeons should be familiar with this combined procedure.