Urinary straining contributes to inguinal hernia after radical retropubic prostatectomy

Yasuhiro Kaiho, Koji Mitsuzuka, Shigeyuki Yamada, Hideo Saito, Hisanobu Adachi, Shinichi Yamashita, Hideaki Izumi, Akihiro Ito, Yoichi Arai

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Objectives: To verify whether abdominal pressure during urination represents an important factor in the postoperative development of inguinal hernia after radical retropubic prostatectomy. Methods: Participants comprised 228 patients who underwent radical retropubic prostatectomy without prophylaxis for inguinal herniation between 2002 and 2007. Development of inguinal hernia was assessed from clinical records. Straining was rated on a six-point scale (straining score) according to frequency of straining using answers to question 6 of the International Prostate Symptom Score questionnaire preoperatively, and at 1, 3, 6, 12, 18, 24 and 36 months after prostatectomy. Straining scores were compared between patients with and without postoperative inguinal hernia. Multivariate analysis was carried out to identify parameters associated with inguinal hernia development after prostatectomy. Associations between inguinal hernia development and frequency of postoperative urinary straining were also estimated. Results: Straining score in both groups was significantly increased at 1 month after radical retropubic prostatectomy. This increase was significantly greater in the postoperative inguinal hernia group (P < 0.05). Throughout the observation period, postoperative straining scores were higher in the group with postoperative inguinal hernia than in the group without. On multivariate analysis, postoperative urinary straining and previous hernia repair represented significant risk factors for postoperative inguinal hernia. The proportion of patients without inguinal hernia decreased significantly with increasing frequency of postoperative urinary straining. Conclusion: Urinary straining is associated with inguinal hernia development after radical retropubic prostatectomy.

Original languageEnglish
Pages (from-to)478-483
Number of pages6
JournalInternational Journal of Urology
Issue number6
Publication statusPublished - 2016 Jun 1


  • Inguinal hernia
  • Postoperative complications
  • Prostatectomy
  • Urination
  • Urination disorders


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