Anyone have hernia surgery post prostatectomy? Complications?

Posted by richardB @richardblackman, Mar 6, 2024

Anyone have experience with hernia surgery post prostatectomy? Evidently, the normally "routine" abdominal hernia surgery is much more complicated for those who have had prostate surgery. If nothing else, a renewed chance of new side effects (incontinence & ED). My primary doc believes I will need the surgery and it looks like not many hernia surgeons have experience with post prostatectomy patients.

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Profile picture for edinmaryland @edinmaryland

I remember seeing something posted on this a month or so ago but now cannot find it.
I had RARP in January and I believe in April had signs of a possible hernia. I went to urgent care and was told there was a definite bulge. Followed up with primary care who also noticed a bulge and sent me for ultrasound. Ultrasound could not confirm hernia told me could be minor hernia could be muscular
I am now experiencing these symptoms again (tenderness and bulge, nauseousness, headache all day for two days now) I have scheduled an appointment with my primary care.
I read that 20% of males can have hernias following prostatectomy. and this might be higher if there is a history of hernia repair which I have (both sides 30 years ago)
I really do not want to have a hernia
I do not want to have to have a repair if it involves a catheter and set back for my incontinence.
I am only a patient, I tend to think that since the removal of my prostrate which was also enlarged means that besides muscle and nerve rehab some of the parts (intensiveness, guts, etc.) have to get rearranged. I also wonder if the core exercises I have been doing religiously might have either contributed to a small hernia or perhaps I am experiencing muscle pain.
I was also starting to do some heavy lifting carrying boxes full of books and papers up and down stairs moving some cabinets around gardening
has anyone had experience with this?
I am definitely symptomatic
thanks much

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thanks so much Glen
Did you have to have a catheter again?
Was the repair pretty straight forward? I had both sides done about 30 years ago.
I do not want this to cause any regression with my incontinence. i am getting better but very slowly not out of the woods at all
thanks a million

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Profile picture for edinmaryland @edinmaryland

I remember seeing something posted on this a month or so ago but now cannot find it.
I had RARP in January and I believe in April had signs of a possible hernia. I went to urgent care and was told there was a definite bulge. Followed up with primary care who also noticed a bulge and sent me for ultrasound. Ultrasound could not confirm hernia told me could be minor hernia could be muscular
I am now experiencing these symptoms again (tenderness and bulge, nauseousness, headache all day for two days now) I have scheduled an appointment with my primary care.
I read that 20% of males can have hernias following prostatectomy. and this might be higher if there is a history of hernia repair which I have (both sides 30 years ago)
I really do not want to have a hernia
I do not want to have to have a repair if it involves a catheter and set back for my incontinence.
I am only a patient, I tend to think that since the removal of my prostrate which was also enlarged means that besides muscle and nerve rehab some of the parts (intensiveness, guts, etc.) have to get rearranged. I also wonder if the core exercises I have been doing religiously might have either contributed to a small hernia or perhaps I am experiencing muscle pain.
I was also starting to do some heavy lifting carrying boxes full of books and papers up and down stairs moving some cabinets around gardening
has anyone had experience with this?
I am definitely symptomatic
thanks much

Jump to this post

I had prostate removed Feb. 12th and incisional hernia popped out before I had left the hospital.They wanted to wait 6 full months before repairing it.I found a good surgeon who did it 3weeks ago.Heeling slowly but I don’t intend to do any kind of lifting or core exercises until I’m sure I am in the clear even if takes months . Also fighting the incontinence battle.Good luck.

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I remember seeing something posted on this a month or so ago but now cannot find it.
I had RARP in January and I believe in April had signs of a possible hernia. I went to urgent care and was told there was a definite bulge. Followed up with primary care who also noticed a bulge and sent me for ultrasound. Ultrasound could not confirm hernia told me could be minor hernia could be muscular
I am now experiencing these symptoms again (tenderness and bulge, nauseousness, headache all day for two days now) I have scheduled an appointment with my primary care.
I read that 20% of males can have hernias following prostatectomy. and this might be higher if there is a history of hernia repair which I have (both sides 30 years ago)
I really do not want to have a hernia
I do not want to have to have a repair if it involves a catheter and set back for my incontinence.
I am only a patient, I tend to think that since the removal of my prostrate which was also enlarged means that besides muscle and nerve rehab some of the parts (intensiveness, guts, etc.) have to get rearranged. I also wonder if the core exercises I have been doing religiously might have either contributed to a small hernia or perhaps I am experiencing muscle pain.
I was also starting to do some heavy lifting carrying boxes full of books and papers up and down stairs moving some cabinets around gardening
has anyone had experience with this?
I am definitely symptomatic
thanks much

REPLY
Profile picture for heavyphil @heavyphil

Wow, unheard of! Please Tell me he was on Long Island, NY!
Phil

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he works at Hopkins in Columbia, Md. There don't seem to be a lot of surgeons with lots of this type of experience.

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Profile picture for Jerry @jerryegge

I had hernia surgery and my doctor didn’t use mesh. It has now been two years and I’m doing well.
PS my doctor repaired two hernias at the same time, the old fashioned way.

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Wow, unheard of! Please Tell me he was on Long Island, NY!
Phil

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Per some of the other comments which seem pretty consistent (I had hernia surgery last summer following my 2021 Prostate surgery)... Yes, doctors don't mention that you have a higher chance of a hernia if you have prostate surgery, yes, it's more complicated than regular hernia surgery, and I didn't have side effects. However, I assume with any hernia surgery, I had to restrain from my favorite physical activities (swimming, tennis, biking) for the summer. I did continue lots of walking. My advice -- be sure to find a surgeon who's fixed lots of hernias of post prostate surgery folks. The first surgeon I spoke with said she was quite experienced with hernia operations, and had done at least 20 with folks that have had their prostate removed. The second surgeon said he didn't know how many he'd done, but at least in the hundreds. I chose the second. No issues a year later, but the doc did tell me that I now have a higher chance of needing the surgery again.

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Profile picture for heavyphil @heavyphil

Hi Petro, how are you coming along after hernia repair? Did your surgeon use mesh? They all do and I’ve put off my own umbilical repair because the mesh too causes issues….leading to yet another surgery!😖

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I had hernia surgery and my doctor didn’t use mesh. It has now been two years and I’m doing well.
PS my doctor repaired two hernias at the same time, the old fashioned way.

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Profile picture for petro61 @petro61

I've been reading about the various surgical outcomes and post-operative experiences here with great interest. I had a RALP (robot-assisted laparoscopic prostatectomy) in February 2023. Close to 1 year later, I experienced an indirect inguinal hernia on my right side. After extensive research into the causes of inguinal hernia, my surgery seemed like the probable cause. As in the case of others who have posted here, my surgeon immediately went on the defensive, insisting that a connection wasn't possible. Notably, he had never mentioned an inguinal hernia as a possible postoperative complication. This is despite the fact that approximately 12% of men undergoing RALP surgery experience Inguinal hernias ( the number is even higher for open prostatectomy). I found that perplexing. It's not as if this isn't well-published, either. I found numerous large-scale studies in both American and European medical journals that came to the same conclusion. Now, over a year after that odd, shifting bulge was initially discovered, I am about one week into my post-hernia repair recovery. Fortunately, my surgeon was aware of the precautions required to work on someone with a history of RALP surgery, having repaired hernias on a few individuals just like myself in the past.
In the studies I came across, the reasons for an increased risk of inguinal hernia after RALP and open prostatectomy were: a history of smoking, chronic cough, low BMI (body mass index), and the skill of the surgeon. Although, there were possibly unknown factors as well. It was interesting to discover that some surgeons are now employing a modified surgical method related to the treatment of the spermatic cord. The vas deferens, a part of the spermatic cord, is often cut during the procedure, and retracting it can potentially pull the peritoneum (lining of the abdominal cavity) towards the inguinal canal, increasing the likelihood of an inguinal hernia. Who knew!? I can only hope that more surgeons look into this in the future. A surgery caused by another surgery is just one surgery too many! Something I'm sure we can all agree on!

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Hi Petro, how are you coming along after hernia repair? Did your surgeon use mesh? They all do and I’ve put off my own umbilical repair because the mesh too causes issues….leading to yet another surgery!😖

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Wow, this is new to me also *sigh. My husband will probably have RP soon, so I am reading all posts and trying to anticipate and prepare for possible problems since I learned hard way NOT to rely on doctors too much.

I made quick Googling through research papers and newest research kind of blames formation of hernia mostly on technique used during RP.
https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-020-00883-9
In some other papers researchers concluded that experience of the surgeon was also of the greatest importance. They also found that there was connection between incontinence and H formation which they think confirms that overly aggressive surgical maneuvers around pelvic floor can damage fine structures and fascia etc. Being over 80 also increases risk since muscle mass tends to get smaller with age.

All in all - RP procedure obviously can be cause of hernia and it is obviously known phenomenon so WHY nobody mentions that ???? It is just maddening Petro that your surgeon pretended that he has no idea what you were referring to - unbelievable ...

REPLY

I've been reading about the various surgical outcomes and post-operative experiences here with great interest. I had a RALP (robot-assisted laparoscopic prostatectomy) in February 2023. Close to 1 year later, I experienced an indirect inguinal hernia on my right side. After extensive research into the causes of inguinal hernia, my surgery seemed like the probable cause. As in the case of others who have posted here, my surgeon immediately went on the defensive, insisting that a connection wasn't possible. Notably, he had never mentioned an inguinal hernia as a possible postoperative complication. This is despite the fact that approximately 12% of men undergoing RALP surgery experience Inguinal hernias ( the number is even higher for open prostatectomy). I found that perplexing. It's not as if this isn't well-published, either. I found numerous large-scale studies in both American and European medical journals that came to the same conclusion. Now, over a year after that odd, shifting bulge was initially discovered, I am about one week into my post-hernia repair recovery. Fortunately, my surgeon was aware of the precautions required to work on someone with a history of RALP surgery, having repaired hernias on a few individuals just like myself in the past.
In the studies I came across, the reasons for an increased risk of inguinal hernia after RALP and open prostatectomy were: a history of smoking, chronic cough, low BMI (body mass index), and the skill of the surgeon. Although, there were possibly unknown factors as well. It was interesting to discover that some surgeons are now employing a modified surgical method related to the treatment of the spermatic cord. The vas deferens, a part of the spermatic cord, is often cut during the procedure, and retracting it can potentially pull the peritoneum (lining of the abdominal cavity) towards the inguinal canal, increasing the likelihood of an inguinal hernia. Who knew!? I can only hope that more surgeons look into this in the future. A surgery caused by another surgery is just one surgery too many! Something I'm sure we can all agree on!

REPLY
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