JCU - January 2022 - 36

961301
URO
Journal of Clinical UrologyTalebpour et al.
Case Series
New technique of inguinal
hernia repair during prostatectomy
Mohammad Talebpour1, Fatemeh Khatami2,
Maryam Aghaii2 and Seyed Mohammad Kazem Aghamir2
Abstract
Background: Several benefits of inguinal hernia repair concurrent with simple prostatectomy have been proposed
recently. For the first time we represent this surgery in the form of retroperitoneal mesh insertion without an additional
surgical cut for the inguinal hernia repair.
Methods: We selected 19 patients for this trial of a new surgery method. The simple prostatectomy was performed and
from the same surgical cut the hernia sac recognized. Two methods of prostatectomy surgery were undertaken: Millin's and
Freyer's prostatectomy. The retroperitoneal insertion of monofilament polypropylene was undertaken for hernia repair.
Results: All patients were prospectively followed for three years for clinical outcomes and hernia recurrence. No
complications after surgery, including wound infection, pelvic collections, sepsis and recurrence of the hernia were seen.
Conclusions: Our new retroperitoneal mesh insertion technique is safe, effective and simultaneously practical with
simple prostatectomy. This new method is strongly recommended to other surgeons, since it has beneficial results with
no noteworthy raise in operative duration or further complications.
Keywords
Inguinal hernia, prostatectomy, mesh, surgery, prostatectomy
Date received: 24 June 2020; accepted: 20 August 2020
Journal of Clinical Urology
2022, Vol. 15(1) 36 -40
© British Association of
Urological Surgeons 2020
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/2051415820961301
journals.sagepub.com/home/uro
https://doi.org/10.1177/2051415820961301
Introduction
An inguinal hernia happens when some tissue, such as certain
parts of the intestine, protrudes through a weak spot in
the abdominal muscles. One of the common treatment
strategies is surgical procedure, especially in adult men.1
The recurrence of hernias after surgery has been stated in
about 15%, resulting in post-operative pain and disability.2,3
Approximately 5 million inguinal hernia patients
have been reported in the USA, in which 75,000 are recurrent.4
Unfortunately, the outcomes of recurrent hernias are
worse than primary inguinal hernia, so there is an extreme
need to develop new, more effective surgical methods.
Endoscopic mini/less open sublay technique (EMILOS),
mini-or less-open sublay technique (MILOS), vacuum
suction fixation and staple fixation in trans-abdominal preperitoneal
inguinal hernia repair (TAPP) are some examples
of the proposed methods.5-7 The majority of current
approaches rely on using mesh to increase the efficacy of
inguinal hernia treatment.8 Surgeons frequently apply surgical
mesh to strengthen the hernia repair and decrease its
recurrence rate. In 1958, for the first time, Usher suggested
the use of polypropylene mesh and within about 30 years,
mesh was popularized for hernia repair. Today, more than
1 million meshes are used per year worldwide.9
On the other hand, there are two different surgery
methods for simple prostatectomy: Freyer's and Millin's
1 Department of General Surgery, Tehran University of Medical
Sciences, Iran
2Urology Research Center, Tehran University of Medical Sciences, Iran
Corresponding author:
Dr Seyed Mohammad Kazem Aghamir, Department of General
Surgery, Tehran University of Medical Sciences, Sina Hospital, Hassan
Abad Sq., Imam Khomeini Ave., Tehran, Iran.
Email: mkaghamir@tums.ac.ir
https://uk.sagepub.com/en-gb/journals-permissions https://www.doi.org/10.1177/2051415820961301 https://journals.sagepub.com/home/uro

JCU - January 2022

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