Surgical Implications of Prior Inguinal Hernia Repair in Extraperitoneal Radical Prostatectomy.

Background: Inguinal hernia repair (IHR) is a common procedure, and patients with a history of IHR may later require radical prostatectomy. Prior IHR can complicate prostatectomy by altering anatomy, but its impact on extraperitoneal laparoscopic radical prostatectomy (ELRP) remains unclear. This study evaluates the feasibility and outcomes of ELRP in patients with prior IHR.

Materials and methods: This retrospective cross-sectional study included male patients aged 40-80 who underwent ELRP for localized prostate cancer between 2019 and 2024. Patients were stratified into two groups based on prior IHR status (group 1: without IHR; group 2: with IHR). Comparative analyses were performed on demographic data, perioperative metrics, and oncological outcomes to assess the impact of prior IHR on ELRP. Statistical significance was accepted as P < .05.

Results: A total of 255 patients (group 1: 220, group 2: 35) were included. No significant differences were found between the groups in terms of age and demographic characteristics. However, the operation duration was longer in group 2 (194.86 vs 176.87 minutes, P = .002), and peritoneal opening occurred more frequently (34.3% vs 9.1%, P < .001). There was no significant difference in the rates of pelvic lymph node dissection (PLND) (25.9% vs 28.5%, P = .149).

Concluison: ELRP outcomes in patients with a history of IHR are similar to standard ELRP. However, when planning surgery for this group, the risk of peritoneal opening, prolonged operation time, and the careful execution of lymph node dissection should be considered.