ABSTRACT
Background: Benign prostatic hyperplasia [BPH] is one of the common problems in older men which in many cases need to be treated. However, the incidence of inguinal hernia increases with age and a significant number of patients with symptoms of BPH, have concurrent inguinal hernia. Although simultaneous suprapubic prostatectomy and inguinal herniorrhaphy is one of the treatment options, but routinely it is not used. This study was aimed to evaluate the results of this surgical procedure
Methods: In this study. 122 patients who were underwent open suprapubic prostatectomy and simultaneous preperitoneal herniorrhaphy with polypropylene mesh application, were evaluated and outcomes and complications of this procedure was recorded
Results: Of 122 patients were enrolled, 38 [31.1%] patients had bilateral inguinal hernia, of 170 hernias, 29 were direct inguinal hernia and 141 were indirect, of 84 patients with unilateral hernia 33 patients had inguinal hernia on the left side and 51 patients on the right side. The median clinical follow-up time was 26.4 months [range 1248 months]. During the follow-up period, surgical site infection, hematoma, chronic pain and hernia recurrence were not detected
Three patients [2.5%] had hydrocele after surgery. In all patients, the surgical outcomes were satisfactory
Conclusions: According to the results, simultaneous prostatectomy and preperitoneal herniorrhaphy with mesh application is a convenient procedure which can be easily performed, furthermore it is cost effective, time-saving and achieves good outcomes for patients
Subject(s)
Humans , Prostatic Hyperplasia/surgery , Herniorrhaphy/methods , Surgical Mesh , Evaluation Studies as Topic , Hernia, Inguinal/surgery , Treatment OutcomeABSTRACT
Aims: Lower urinary tract symptoms (LUTS) are common in aging men. Benign prostatic hyperplasia (BPH) develops with advancing age. The incidence of inguinal hernia also increases with age. A significant number of elderly men with symptoms of BPH have inguinal hernia at the same time. Simultaneous preperitoneal inguinal hernia repair with other pelvic surgeries has been described, but it was not popular among urologists and general surgeons mainly because of high recurrence rate. Study Design: Prospective study. Place and Duration of Study: Department of Urology, Tabriz University of Medical Sciences, Imam Reza Hospital, between March 2010 and September 2013 Methodology: We evaluated the outcomes and complications of 37 patients who underwent open transvesical prostatectomy and simultaneous bilateral preperitoneal herniorrhaphy with application of polypropylene mesh Results: Twelve patients with bilateral direct hernia, 24 patients with bilateral indirect hernia and one patient with right side direct and left side indirect inguinal hernia were enrolled in our study. Four patients (10.8%) had bilateral recurrent hernias and 2 others (5.4%) had recurrent hernia on one side and primary hernia on the other side. Mean operation time was 86 minutes (71-110). The mean blood loss during surgery was 578 (240-1250)ml. The median clinical follow-up time was 13.7 months. During follow-up period surgical site infection, hematoma, chronic pain and recurrence were not detected. One (2.7%) lymphocele formation was detected. In all patients, the surgical outcomes were satisfactory. Conclusion: Simultaneous prostatectomy and preperitoneal herniorrhaphy with mesh application, is a convenient and safe procedure which can be performed easily by urologists. This procedure is both cost effective and time-saving and achieves long term beneficial outcomes for patients.
ABSTRACT
Background and Objectives:Radical Nephrectomy [RN] is a standard treatment modality for localized Renal Cell Carcinoma [RCC], and recently laparoscopic RN is coming popular for RCC treatment. The advantages of retroperitoneal laparoscopy to the intraperitoneal approach include less visceral and vascular injury, easier access to renal vessels and no peritoneal seeding. Accordingly that in our country intraperitoneal approach is known as acommon option, we decided to report our experience in retroperitoneal laparoscopic RN in these patients
Materials and Methods: In this retrospective study, 12 patients [6 male and 6 female] with 3-11 cm renal masses who were hospitalized from 2008 to 2012, underwent the retroperitoneal laparoscopic RN with hand assisted intact kidney removal by Gibson incision, assessed for local recurrence, perioperative hemorrhage and other postoperative complications
Results: Mean operation time was 193 +/- 32 min with during operation blood loss of 162 +/- 48 ml. Post operation hospital stay was 2-5 days. Conversion to open surgery was not required. There was no blood transfusion during and post operation. No major complication occurred. At mean 47.5 +/- 18 months fallow up local recurrence was not seen
Conclusion: Retroperitoneal laparoscopic RN has become safe, simplified and effective although not easy.Complications, blood loss, hospital stay and convalescence times are low, therefore this approach is a good option for selected case of renal mass