Combined inguinal herniorrhaphy and transurethral prostatectomy

Transurethral Resection of the Prostate (TURP) and concomitant inguinal hernioplasty: a single-center experience

BACKGROUND

Benign prostatic hyperplasia (BPH) is a prevalent condition in aging males, leading to bladder outlet obstruction (BOO) and associated urinary symptoms. With increasing life expectancy, the incidence of BPH and its co-morbidities, like inguinal hernia, has risen. This study explores the efficacy of combining transurethral resection of the prostate (TURP) and inguinal hernioplasty in a single surgical session to address both conditions, potentially reducing the need for multiple hospitalizations and surgical interventions.

METHODS

This retrospective study at Chi Mei Medical Center included patients from 2014 to 2023 who underwent concurrent TURP and inguinal hernioplasty. A total of 85 patients met the criteria defined for this study. Preoperative, intraoperative, and postoperative characteristics were meticulously documented. Outcomes evaluated included the duration of the surgery, incidence of intraoperative and postoperative complications, duration of Foley catheterization, length of hospital stay, and treatment efficacy. Additionally, we conducted a comparative assessment of the surgical outcomes between two distinct techniques for inguinal hernia repair: open hernioplasty and laparoscopic hernioplasty (LH).

RESULTS

In 85 patients who met the criteria, the mean age was 71.1 ± 7.8 years. The study reported no significant intraoperative complications, and postoperative care was focused on monitoring for blood loss, infection, and managing pain. The average postoperative hospital stay was 2.9 ± 1.0 days and the mean duration of catheterization was 51.6 ± 16.7 h, with a minimal complication rate observed during the one-year follow-up. A significant reduction in both operative duration and catheterization interval was observed in patients undergoing LH as opposed to those receiving open hernioplasty.

CONCLUSION

Concurrent TURP and inguinal hernioplasty effectively manage BOO due to BPH and inguinal hernias with minimal complications, suggesting a viable approach to reducing hospital stays and surgical interventions. Laparoscopic techniques, in particular, offer benefits in operative efficiency and recovery time, making combined surgery a feasible option for selected patients.

[Combined inguinal hernia repair and transurethral resection of the prostate (TURP) for benign prostatic hypertrophy]

OBJECTIVE

Our aim was to evaluate the outcome of transurethral resection of prostate (TURP) and inguinal hernia repair performed in a single session.

METHODS

Data was obtained retrospectively for 31 patients (mean age 65 years) who underwent simultaneous TURP and inguinal hernia repair. Most patients had lower urinary tract symptoms related to BPH such as acute urinary retention, recurrent bladder retention, or severe dysuria. Twenty-one patients had simple inguinal hernia and ten had large inguinoscrotal hernia. Operations were performed in 23 patients under spinal anesthesia. Bassini's operation was the most common herniorrhaphy technique (23 patients).

RESULTS

We observed good outcomes in 86% of the patients. The morbidity rate was 10.7%, the mean postoperative stay was 3.6 days (2-6 days). There was no recurrence of inguinal hernia.

CONCLUSION

Combining TURP and inguinal hernia repair in one session decreases the number of procedures and anesthesias, hospital stay, and thus direct health costs and does not result in an increase in operative or postoperative morbidity.

Combined transurethral prostatectomy and inguinal hernioplasty

AIM

Evaluation of combined transurethral resection of the prostate (TURP) and inguinal hernia repair with Vypro II mesh in comparison with patients undergoing TURP and hernioplasty sequentially.

METHODS

Thirty patients were randomly categorized into two groups through a computer randomization program. Group I included 15 patients operated by TURP and inguinal hernioplasty in the same session. Group II included 15 patients operated by TURP followed by inguinal hernioplasty in separate sessions.

RESULTS

The mean operative time was 84.6 +/- 23.4 min in group I versus 95.5 +/- 15.3 min in group II. The mean hospitalization time was 3.07 +/- 0.46 days in group I and 4.07 +/- 0.59 days in group II. No significant increase in the complication rate was seen when the TURP and inguinal hernioplasty operations were performed together. Hernia recurrence did not occur in either group. Hospitalization cost was reduced by 26% when performing the two operations in the same session. The numerical patient satisfaction score 3 months after surgery was 8.87 +/- 0.99 for group I patients versus 7.80 +/- 0.94 for group II patients.

CONCLUSION

Combined TURP and inguinal hernioplasty is a practical, safe, and effective operative procedure that can reduce hospitalization cost. It allows patients to undergo only one anesthetic procedure, hospital admission, and convalescence.

Combined transurethral resection of prostate and inguinal mesh hernioplasty

We aimed to evaluate the difference among early post-operative morbidities of transurethral resection of prostate (TURP), inguinal herniorrhaphy and their combination in this study. Between 1998 and 2004, 44 patients undergoing combined inguinal herniorrhaphy and TURP (Group I) were compared with 50 consecutive cases of TURP alone (Group II) and 50 consecutive cases of inguinal herniorrhaphy alone (Group III). There were no differences in the mean age and mean prostatic volume between Group I and II. The mean operation time and length of hospital stay were 126.1 +/- 20.9 min, 3.0 +/- 0.7 days for Group I, 61.4 +/- 15.6 min and 2.9 +/- 0.69 days for Group II and 55.0 +/- 15.6 min and 1.2 +/- 0.4 days for Group III, respectively. The mean operation time of Group I was found as longer than Group II and III. There were no significant differences among all groups regarding post-operative complications. No mesh infection was detected. Combined TURP and inguinal herniorrhaphy is a practical, safe and effective procedure.

Combined transurethral prostatectomy and inguinal hernia repair: a retrospective audit and literature review

OBJECTIVE

To audit the results of combined transurethral resection of the prostate (TURP) and inguinal hernia repair, often carried out under the same anaesthetic (because bladder outlet obstruction from prostatic disease and inguinal hernia are both common conditions in elderly men), to avoid two separate operations.

PATIENTS AND METHODS

The study included 85 patients who underwent primary inguinal hernia repair with TURP in the urology unit of Nottingham City hospital between 1989 and 1995, and who were recalled to a special clinic. The type of hernia and repair carried out were recorded and complications audited with specific reference to recurrence of hernia and wound infection.

RESULTS

The 85 patients underwent 88 primary inguinal hernia repairs with TURP (three were bilateral). Maloney's darn repair was used on 55 and a Bassini repair on 33 occasions, respectively. Two patients developed mild wound infection after surgery, but only two patients (2%) had recurrence of hernia.

CONCLUSIONS

The recurrence rate after primary inguinal herniorraphy with conventional methods of repair, performed with TURP, was comparable with published results of hernia repairs alone, before the introduction of Lichtenstein's mesh repair.