Miyajima Akira
Department of Urology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Int J Urol. 2018 Jul;25(7):644-648. doi: 10.1111/iju.13717. Epub 2018 Jun 19.
With an increase in their prevalence, it has become apparent that both benign prostatic hyperplasia and radical prostatectomy for cancer can induce inguinal hernia development. An inguinal hernia is a common late complication following radical prostatectomy, with an occurrence rate of 12-25%. Following radical prostatectomy, the space of Retzius can develop adhesions to surrounding tissue, often causing difficulty during inguinal hernia repair. Conversely, inguinal hernia repair before radical prostatectomy also induces severe adhesions around the space of Retzius and causes difficulty during radical prostatectomy. The association between radical prostatectomy and inguinal hernia development is complex and unclear. Both urologists and surgeons are challenged by this interaction. The surgical approaches for prostate cancer have undergone a major transition from open surgery to robotic surgery, and the treatment of inguinal hernia is also changing. Based on historical trends, several preventive and treatment measures have been proposed, although there is no direct evidence for risk factors that lead to inguinal hernia development. This article focuses on the complex interaction between the prostate and inguinal hernia, and considers preventive measures against inguinal hernia development.
随着良性前列腺增生和前列腺癌根治术的患病率增加，很明显这两种疾病都可诱发腹股沟疝的发生。腹股沟疝是前列腺癌根治术后常见的晚期并发症，发生率为12% - 25%。前列腺癌根治术后，耻骨后间隙可与周围组织形成粘连，常在腹股沟疝修补术中造成困难。相反，在前列腺癌根治术前进行腹股沟疝修补术也会在耻骨后间隙周围诱发严重粘连，并在前列腺癌根治术中造成困难。前列腺癌根治术与腹股沟疝发生之间的关联复杂且不明确。泌尿外科医生和外科医生都受到这种相互作用的挑战。前列腺癌的手术方式已从开放手术向机器人手术发生了重大转变，腹股沟疝的治疗也在发生变化。基于历史趋势，尽管没有导致腹股沟疝发生的危险因素的直接证据，但已提出了几种预防和治疗措施。本文重点关注前列腺与腹股沟疝之间的复杂相互作用，并探讨预防腹股沟疝发生的措施。
