One or two years after radical prostatectomy, about
15 percent of men turn out to have inguinal hernias. Patrick C.
Walsh, M.D., has been interested in this phenomenon since he first
noticed it several years ago. He believes that many of these hernias
may have been present before surgery—but they just weren’t diagnosed.
With this idea in mind, he and Matthew E. Nielson,
M.D., a resident at the Brady Urological Institute, studied 430
patients who underwent surgery between September 2001 and December
2004. The extra scrutiny paid off: "We found that if one looks very
carefully at the time of surgery, about onethird of patients have
hernias," he says, "and in 40 percent of these patients, the hernias
were on both sides." These hernias were repaired during the radical
prostatectomy procedure. Although none of the hernias that were
repaired came back, a few of these men — 5 percent — developed another
hernia after surgery, at a new site.
This study suggests that at the time of radical
prostatectomy, urologists should carefully examine the patient for
the presence of a hidden hernia, "and if one is found, it should
be repaired," Walsh says. "We hope this will significantly reduce
the development of a hernia following surgery."