JCU - January 2022 - 38

38
Journal of Clinical Urology 15(1)
wound infection, pelvic collections, urinary fistula and
recurrence of the hernia, were assessed.
Discussion
Not only does the usual surgical method for inguinal hernia
repair require a surgical cut, there is also the risk of
hernia recurrence, which is associated with the same side
effects and worse outcomes. Here we present a novel surgical
method of simple prostatectomy and retroperitoneal
insertion of mesh for hernia repair from the same surgical
cut, with a hernia recurrence rate of 0.
Figure 1. Schematic presentation of the way of using
propylene mesh in simultaneous simple prostatectomy and
hernia repair.
hole in order to pass the cord through. After that, the mesh
is placed in the pelvis over an internal ring after separating
the cord's sac and is fixed in the pelvis (Figure 1).
In order not to make contact with the anastomosis,
some additional mesh was discarded by cutting. For bilateral
hernia repair, the process was undertaken on the opposite
side as well. There was no antiseptic lavage of the
surgical field after placing the mesh, and a femoral drain
was implanted in the prevesical space, externalized over
the minor edge of the incision and removed four days after
surgery, very carefully to avoid drain contact with the
mesh. The surgical procedure is shown in Figure 2. Patients
were told to avoid heavy lifting and excessive physical
exercise. They were also told to report any discomfort or
pain to the clinicians. The patients were followed for
almost six months, regarding any possible complications.
All complications arising from the surgery, including
Several studies have proposed simultaneous inguinal
hernia repair and prostatectomy through two different
independent surgical cuts and not using the retroperitoneal
mesh.12-16 An inguinal hernia repair concomitant
with prostatectomy was firstly reported by McDonald and
Huggins, however this was performed with two separate
incisions, with the hernia defect repaired through the
inguinal approach.17-19 After that, the Pfannenstiel-Kerr
incision or pubic incision, that allows access to the abdomen,
was suggested for the hernia repair meanwhile performing
a simple prostatectomy.20 In order to decrease the
recurrence rate of hernia it is suggested that, based upon
the Nyhus technique, the transverse arches estimated to
the iliopubic tract with interrupted polypropylene sutures
before the initial sutures are employed to Cooper's ligament
to close the femoral canal.21 However, the weak
point of the Nyhus procedure was the subsequent and
extraordinary tension on the repair, which is normally
unacceptable. This tension can increase after the closing
of the abdominal incision, and results in a high hernia
recurrence rate (c. 6.6%)22.
The use of mesh in relation to repairing hernias is the
technique most likely to reduce potential protrusion of
the abdominal content.23 Several studies confirmed the
low risk of hernia recurrence after using mesh, both during
prostate surgery and alone.24,25 None of these studies,
however, suggested the prostatectomy and hernia repair
Figure 2. Photographs of the procedure: (a) the monofilament polypropylene mesh 6 × 11 cm before surgery; (b) the
prostatectomy; (c) end of surgery.

JCU - January 2022

Table of Contents for the Digital Edition of JCU - January 2022

Contents
JCU - January 2022 - Cover1
JCU - January 2022 - Contents
JCU - January 2022 - 2
JCU - January 2022 - 3
JCU - January 2022 - 4
JCU - January 2022 - 5
JCU - January 2022 - 6
JCU - January 2022 - 7
JCU - January 2022 - 8
JCU - January 2022 - 9
JCU - January 2022 - 10
JCU - January 2022 - 11
JCU - January 2022 - 12
JCU - January 2022 - 13
JCU - January 2022 - 14
JCU - January 2022 - 15
JCU - January 2022 - 16
JCU - January 2022 - 17
JCU - January 2022 - 18
JCU - January 2022 - 19
JCU - January 2022 - 20
JCU - January 2022 - 21
JCU - January 2022 - 22
JCU - January 2022 - 23
JCU - January 2022 - 24
JCU - January 2022 - 25
JCU - January 2022 - 26
JCU - January 2022 - 27
JCU - January 2022 - 28
JCU - January 2022 - 29
JCU - January 2022 - 30
JCU - January 2022 - 31
JCU - January 2022 - 32
JCU - January 2022 - 33
JCU - January 2022 - 34
JCU - January 2022 - 35
JCU - January 2022 - 36
JCU - January 2022 - 37
JCU - January 2022 - 38
JCU - January 2022 - 39
JCU - January 2022 - 40
JCU - January 2022 - 41
JCU - January 2022 - 42
JCU - January 2022 - 43
JCU - January 2022 - 44
JCU - January 2022 - 45
JCU - January 2022 - 46
JCU - January 2022 - 47
JCU - January 2022 - 48
JCU - January 2022 - 49
JCU - January 2022 - 50
JCU - January 2022 - 51
JCU - January 2022 - 52
JCU - January 2022 - 53
JCU - January 2022 - 54
JCU - January 2022 - 55
JCU - January 2022 - 56
JCU - January 2022 - 57
JCU - January 2022 - 58
JCU - January 2022 - 59
JCU - January 2022 - 60
JCU - January 2022 - 61
JCU - January 2022 - 62
JCU - January 2022 - 63
JCU - January 2022 - 64
JCU - January 2022 - 65
JCU - January 2022 - 66
JCU - January 2022 - 67
JCU - January 2022 - 68
JCU - January 2022 - 69
JCU - January 2022 - 70
JCU - January 2022 - 71
JCU - January 2022 - 72
JCU - January 2022 - 73
JCU - January 2022 - 74
JCU - January 2022 - 75
JCU - January 2022 - 76
JCU - January 2022 - 77
JCU - January 2022 - 78
JCU - January 2022 - Cover3
JCU - January 2022 - Cover4
https://www.nxtbookmedia.com