Bilateral vas deferens suturing to prevent inguinal hernias after radical prostatectomy

Abstract

Objectives

To evaluate the efficacy and safety of bilateral vas deferens sutures in preventing postoperative inguinal hernia after prostatectomy for clinically localized prostate cancer.

Materials and Methods

This retrospective study included 282 patients with localized prostate cancer who underwent open or laparoscopic radical prostatectomy between July 2012 and July 2023. The inguinal hernia incidence rates were compared between the vas deferens suture group (141 patients, May 2017 to July 2023) and the control group (141 patients, July 2012 to April 2017). We further determined the risk factors for inguinal hernia after prostatectomy using a multivariate regression analysis.

Results

Among the 282 patients analysed, postoperative inguinal hernia was observed in 10 (7.1%) and 37 (26.2%) patients in the vas deferens suture and control groups, respectively. The incidence differed significantly between patients who did and did not undergo radical prostatectomy with a prophylactic procedure (P = 0.006). The 2-year inguinal hernia-free rates were 93.4% and 85.1% in the vas deferens suture and control groups, respectively. The median duration for inguinal hernia development was 15 months. Multivariate analysis identified the vas deferens suture procedure as a single factor associated with protection against inguinal hernia development after radical prostatectomy (hazard ratio, 0.36; 95% confidence interval, 0.177–0.734; P = 0.005).

Conclusions

The vas deferens suture is a simple and safe prophylactic procedure to decrease the risk of inguinal hernia after radical prostatectomy.