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Byung Ha Chung - One of the best experts on this subject based on the ideXlab platform.

  • A Simple Procedure to Prevent Postoperative Inguinal Hernia after Robot-Assisted Laparoscopic Radical Prostatectomy: A Plugging Method of the Internal Inguinal Floor for Patients with Patent Processus vaginalis
    The Journal of urology, 2013
    Co-Authors: Dong Hoon Lee, Seung Hwan Lee, Kyo Chul Koo, Byung Ha Chung
    Abstract:

    Purpose: We introduce a simple procedure to prevent postoperative inguinal hernia after robot-assisted laparoscopic radical prostatectomy. We developed the inguinal hernia prevention procedure based on our prior study. Patent Processus vaginalis is an independent predictor of inguinal hernia after robot-assisted laparoscopic radical prostatectomy.Materials and Methods: We reviewed 74 patients (98 groins) with patent Processus vaginalis during robot-assisted laparoscopic radical prostatectomy between May 2007 and April 2013. Of these patients 38 (47 groins) did not undergo the inguinal hernia prevention procedure and 36 (51 groins) were treated with this procedure. For the inguinal hernia prevention the lateral side internal inguinal floor of the patent Processus vaginalis was incised and dissected along the spermatic cord. Hemostatic agents were plugged into the end of the dissected canal. After plugging, the internal inguinal floor was closed. We compared the incidence of postoperative inguinal hernia be...

  • patent Processus vaginalis in adults who underwent robot assisted laparoscopic radical prostatectomy predictive signs of postoperative inguinal hernia in the internal inguinal floor
    International Journal of Urology, 2013
    Co-Authors: Dong Hoon Lee, Ha Bum Jung, Mun Su Chung, Seung Hwan Lee, Byung Ha Chung
    Abstract:

    Objective:  To evaluate the risk for postoperative inguinal hernia according to the presence of patent Processus vaginalis in an adult population. Methods:  Medical records of 205 patients who underwent robot-assisted laparoscopic radical prostatectomy from May 2007 to November 2011 were reviewed. Age, prostate-specific antigen, prostate volume, body mass index, operative time and history of previous abdominal surgery were evaluated. The existence of patent Processus vaginalis was also evaluated for the development of postoperative inguinal hernia. Results:  Postoperative inguinal hernia occurred in 20 out of 410 (4.9%) groins (17/205 patients; 8.3%), and patent Processus vaginalis was observed in 49 out of 410 (11.9%) groins. In the normal groin group, inguinal hernia occurred in seven out of 361 (1.9%) groins. However, in the patent Processus vaginalis group, it occurred in 13 out of 49 (26.5%) groins. On univariate analysis using Cox proportional hazards model, age, body mass index, history of previous abdominal surgery and patent Processus vaginalis were significant risk factors. Among them, patent Processus vaginalis significantly increased the risk of postoperative inguinal hernia in multivariate analysis (hazard ratio 22.37). In the patent Processus vaginalis group, inguinal hernia developed at 12.9 ± 9.2 months after robot-assisted laparoscopic radical prostatectomy and 15 ± 7.4 months in the normal groin group. Inguinal hernia-free ratios were significantly lower in the patent Processus vaginalis group than the normal groin group (P < 0.001). Conclusions:  The existence of patent Processus vaginalis represents an important risk factor for postoperative inguinal hernia in adults. Urologists should consider the possibility of postoperative inguinal hernia when patent Processus vaginalis is observed during surgery.

  • Patent Processus vaginalis in adults who underwent robot-assisted laparoscopic radical prostatectomy: Predictive signs of postoperative inguinal hernia in the internal inguinal floor
    International journal of urology : official journal of the Japanese Urological Association, 2012
    Co-Authors: Dong Hoon Lee, Ha Bum Jung, Mun Su Chung, Seung Hwan Lee, Byung Ha Chung
    Abstract:

    Objective:  To evaluate the risk for postoperative inguinal hernia according to the presence of patent Processus vaginalis in an adult population. Methods:  Medical records of 205 patients who underwent robot-assisted laparoscopic radical prostatectomy from May 2007 to November 2011 were reviewed. Age, prostate-specific antigen, prostate volume, body mass index, operative time and history of previous abdominal surgery were evaluated. The existence of patent Processus vaginalis was also evaluated for the development of postoperative inguinal hernia. Results:  Postoperative inguinal hernia occurred in 20 out of 410 (4.9%) groins (17/205 patients; 8.3%), and patent Processus vaginalis was observed in 49 out of 410 (11.9%) groins. In the normal groin group, inguinal hernia occurred in seven out of 361 (1.9%) groins. However, in the patent Processus vaginalis group, it occurred in 13 out of 49 (26.5%) groins. On univariate analysis using Cox proportional hazards model, age, body mass index, history of previous abdominal surgery and patent Processus vaginalis were significant risk factors. Among them, patent Processus vaginalis significantly increased the risk of postoperative inguinal hernia in multivariate analysis (hazard ratio 22.37). In the patent Processus vaginalis group, inguinal hernia developed at 12.9 ± 9.2 months after robot-assisted laparoscopic radical prostatectomy and 15 ± 7.4 months in the normal groin group. Inguinal hernia-free ratios were significantly lower in the patent Processus vaginalis group than the normal groin group (P 

John M. Hutson - One of the best experts on this subject based on the ideXlab platform.

  • Enlargement of the Processus vaginalis during testicular descent in rats.
    Pediatric surgery international, 2001
    Co-Authors: M. Ramasamy, N. Di Pilla, T. Yap, Zoltan Hrabovszky, P. J. Farmer, John M. Hutson
    Abstract:

    The role of the Processus vaginalis (PV) during inguinoscrotal testicular descent remains controversial. Some authors propose passive dragging of the PV by the migrating testis, while others suggest active elongation. In addition, the exact site of growth is unknown. Our aim was to determine whether the PV actively proliferates at its tip or stretches passively during the inguinoscrotal phase of descent in the rat. Gubernacula were removed from Sprague-Dawley (SD) rats and congenitally-cryptorchid TS mutants. Animals (at days 3, 7, 10, and 11) were treated with bromo-uridine deoxyribose (BUdR) 2 h before death. BUdR incorporation into newly-synthesised DNA served as a marker for cell division. The gubernacula were processed for haematoxylin and eosin and immunoperoxidase staining. Three sites were examined: (1) the tip of the PV on either side of the gubernacular bulb; (2) the proximal gubernacular cord; and (3) the proximal parietal PV. At each site, 50 adjacent cells were counted and the number of positive cells recorded. The highest BUdR labelling in SD rats was at the tip (site 1) on day 3 (17/50) compared with sites 2 (11/50) and 3 (9/50) (P < 0.05). Labelling decreased by 7 and 11 days to similar levels in all three sites. In TS rats, labelling rates were lower at day 3 and were highest at the tip at day 11. These results suggest active growth of the caudal tip of the PV during testicular descent. In normal rats, the growth rate slows as the testis approaches the scrotum. By contrast, in TS rats growth continued longer. We propose that the PV elongates actively from the tip to allow the intraperitoneal testis to leave the abdomen in a special peritoneal diverticulum.

  • The development and closure of the Processus vaginalis
    Hernia, 1999
    Co-Authors: Thomas D. Clarnette, John M. Hutson
    Abstract:

    It is now well known that the failure of the Processus vaginalis (PV) to close off following descent of the testis not only accounts for nearly all inguinal hernias of childhood [Rothenberg et al, 1953], but also for other common congenital conditions of childhood such as scrotal hydroceles and encysted hydroceles of the cord. Despite the direct relationship of the PV to these conditions and its intimate association with the mechanism of testicular descent, surprisingly little is known about this important structure. It is not known, for instance, how the PV develops, what precise role it plays in testicular descent, what makes it close, or exactly when it closes. The purpose of this paper is to review the past and present literature on the PV, examining specifically its role in testicular descent, its postulated modes of development, and the mechanisms of its closure and disappearence following descent of the testis.

  • Ventriculo-peritoneal shunts in children reveal the natural history of closure of the Processus vaginalis
    Journal of pediatric surgery, 1998
    Co-Authors: Thomas D. Clarnette, Simon K. L. Lam, John M. Hutson
    Abstract:

    Abstract Purpose: Little information is known about the natural history of closure of the Processus vaginalis. The authors studied children who had ventriculoperitoneal shunts to determine the natural history of closure of the Processus vaginalis and to better understand the role of intraabdominal pressure in the etiology of congenital inguinal hernia. Materials and Methods: A retrospective review of all children undergoing insertion of ventriculoperitoneal shunts between 1985 and 1995 at the Royal Children's Hospital was undertaken. In each case, the sex, the cause of hydrocephalus, the age at insertion of the shunt, and the subsequent development of an inguinal hernia or hydrocele was recorded. Results: There were 430 children in the study. An inguinal hernia developed in 15% of children after insertion of a ventriculoperitoneal shunt, and a hydrocele developed in an additional 6% of boys. Inguinal hernias were bilateral in 47% of boys and 27% of girls. The incidence of subsequent development of an inguinal hernia or hydrocele was closely related to the age of insertion of the ventriculoperitoneal shunt, being 30% during the last 8 weeks of gestation and the first few months of life, then falling quite sharply to reach about 10% at 1 year. Conclusions: The high occurrence of inguinal hernias and hydroceles after ventriculoperitoneal shunt insertion supports the role of raised intraabdominal pressure in the etiology of these conditions. It appears that raised intraabdominal pressure is associated with an increased incidence of clinical hernias, but not with increased incidence of patency of the Processus vaginalis. The development of an inguinal hernia or hydrocele after inserton of a ventriculoperitoneal shunt can be used as an indirect marker of patency of the Processus vaginalis at the time of insertion of the shunt. From this, we propose that the Processus vaginalis remains patent in at least 30% of children in the first few months of life, after which time the patency rate appears to fall off quite sharply.

  • Shunts in Children Reveal the Natural History of Closure of the Processus vaginalis
    1998
    Co-Authors: Thomas D. Clarnette, John M. Hutson
    Abstract:

    Materialsand Methods:A retrospective review of all children undergoing insertion of ventriculoperitoneal shunts between 1985 and 1995 at the Royal Children’s Hospital was undertaken. In each case, the sex, the cause of hydrocephalus, the age at insertion of the shunt, and the subsequent development of an inguinal hernia or hydrocele was recorded. Results: There were 430 children in the study. An inguinal hernia developed in 15% of children after insertion of a ventriculoperitoneal shunt, and a hydrocele developed in an additional 6% of boys. lnguinal hernias were bilateral in 47% of boys and 27% of girls. The incidence of subsequent development of an inguinal hernia or hydrocele was closely related to the age of insertion of the ventriculoperitoneal shunt, being 30% during the last 8 weeks of gestation and the first few months of life, then falling quite sharply to reach about 10% at 1 year. Conclusions: The high occurrence of inguinal hernias and hydroceles after ventriculoperitoneal shunt insertion supports the role of raised intraabdominal pressure in the etiology of these conditions. It appears that raised intraabdominal pressure IS associated with an increased incidence of clinical hernias, but not with increased incidence of patency of the Processus vaginalis. The development of an inguinal hernia or hydrocele after insertion of a ventriculoperitoneal shunt can be used as an indirect marker of patency of the Processus vaginalis at the time of insertion of the shunt. From this, we propose that the Processus vaginalis remains patent in at least 30% of children in the first few months of life, after which time the patency rate appears to fall off quite sharply. J Pediatr Surg 33:473-416. Copyright o 1998 by W.B. Saunders Company.

  • is the ascending testis actually stationary normal elongation of the spermatic cord is prevented by a fibrous remnant of the Processus vaginalis
    Pediatric Surgery International, 1997
    Co-Authors: Thomas D. Clarnette, John M. Hutson
    Abstract:

    The Processus vaginalis (PV) forms as a peritoneal diverticulum within the gubernaculum testis to allow the testis to exit from the abdominal cavity. Failure of its closure leads to inguinal hernias and hydroceles. Ascending testis, which is likely to be an acquired form of undescended testis, may also be part of the spectrum of failure of regression of the PV At orchidopexy for cryptorchidism in older boys with a history of a scrotal testis in infancy, we find that the PV persists as a fibrous string, preventing normal elongation of the vas deferens and gonadal vessels with increasing size of the boy. We propose that the ascending testis is actually ‘stationary’, and is caused by persistence of a fibrous remnant of the PV Seen in this light, ascending testes are directly related to inguinal hernias.

Dong Hoon Lee - One of the best experts on this subject based on the ideXlab platform.

  • A Simple Procedure to Prevent Postoperative Inguinal Hernia after Robot-Assisted Laparoscopic Radical Prostatectomy: A Plugging Method of the Internal Inguinal Floor for Patients with Patent Processus vaginalis
    The Journal of urology, 2013
    Co-Authors: Dong Hoon Lee, Seung Hwan Lee, Kyo Chul Koo, Byung Ha Chung
    Abstract:

    Purpose: We introduce a simple procedure to prevent postoperative inguinal hernia after robot-assisted laparoscopic radical prostatectomy. We developed the inguinal hernia prevention procedure based on our prior study. Patent Processus vaginalis is an independent predictor of inguinal hernia after robot-assisted laparoscopic radical prostatectomy.Materials and Methods: We reviewed 74 patients (98 groins) with patent Processus vaginalis during robot-assisted laparoscopic radical prostatectomy between May 2007 and April 2013. Of these patients 38 (47 groins) did not undergo the inguinal hernia prevention procedure and 36 (51 groins) were treated with this procedure. For the inguinal hernia prevention the lateral side internal inguinal floor of the patent Processus vaginalis was incised and dissected along the spermatic cord. Hemostatic agents were plugged into the end of the dissected canal. After plugging, the internal inguinal floor was closed. We compared the incidence of postoperative inguinal hernia be...

  • patent Processus vaginalis in adults who underwent robot assisted laparoscopic radical prostatectomy predictive signs of postoperative inguinal hernia in the internal inguinal floor
    International Journal of Urology, 2013
    Co-Authors: Dong Hoon Lee, Ha Bum Jung, Mun Su Chung, Seung Hwan Lee, Byung Ha Chung
    Abstract:

    Objective:  To evaluate the risk for postoperative inguinal hernia according to the presence of patent Processus vaginalis in an adult population. Methods:  Medical records of 205 patients who underwent robot-assisted laparoscopic radical prostatectomy from May 2007 to November 2011 were reviewed. Age, prostate-specific antigen, prostate volume, body mass index, operative time and history of previous abdominal surgery were evaluated. The existence of patent Processus vaginalis was also evaluated for the development of postoperative inguinal hernia. Results:  Postoperative inguinal hernia occurred in 20 out of 410 (4.9%) groins (17/205 patients; 8.3%), and patent Processus vaginalis was observed in 49 out of 410 (11.9%) groins. In the normal groin group, inguinal hernia occurred in seven out of 361 (1.9%) groins. However, in the patent Processus vaginalis group, it occurred in 13 out of 49 (26.5%) groins. On univariate analysis using Cox proportional hazards model, age, body mass index, history of previous abdominal surgery and patent Processus vaginalis were significant risk factors. Among them, patent Processus vaginalis significantly increased the risk of postoperative inguinal hernia in multivariate analysis (hazard ratio 22.37). In the patent Processus vaginalis group, inguinal hernia developed at 12.9 ± 9.2 months after robot-assisted laparoscopic radical prostatectomy and 15 ± 7.4 months in the normal groin group. Inguinal hernia-free ratios were significantly lower in the patent Processus vaginalis group than the normal groin group (P < 0.001). Conclusions:  The existence of patent Processus vaginalis represents an important risk factor for postoperative inguinal hernia in adults. Urologists should consider the possibility of postoperative inguinal hernia when patent Processus vaginalis is observed during surgery.

  • Patent Processus vaginalis in adults who underwent robot-assisted laparoscopic radical prostatectomy: Predictive signs of postoperative inguinal hernia in the internal inguinal floor
    International journal of urology : official journal of the Japanese Urological Association, 2012
    Co-Authors: Dong Hoon Lee, Ha Bum Jung, Mun Su Chung, Seung Hwan Lee, Byung Ha Chung
    Abstract:

    Objective:  To evaluate the risk for postoperative inguinal hernia according to the presence of patent Processus vaginalis in an adult population. Methods:  Medical records of 205 patients who underwent robot-assisted laparoscopic radical prostatectomy from May 2007 to November 2011 were reviewed. Age, prostate-specific antigen, prostate volume, body mass index, operative time and history of previous abdominal surgery were evaluated. The existence of patent Processus vaginalis was also evaluated for the development of postoperative inguinal hernia. Results:  Postoperative inguinal hernia occurred in 20 out of 410 (4.9%) groins (17/205 patients; 8.3%), and patent Processus vaginalis was observed in 49 out of 410 (11.9%) groins. In the normal groin group, inguinal hernia occurred in seven out of 361 (1.9%) groins. However, in the patent Processus vaginalis group, it occurred in 13 out of 49 (26.5%) groins. On univariate analysis using Cox proportional hazards model, age, body mass index, history of previous abdominal surgery and patent Processus vaginalis were significant risk factors. Among them, patent Processus vaginalis significantly increased the risk of postoperative inguinal hernia in multivariate analysis (hazard ratio 22.37). In the patent Processus vaginalis group, inguinal hernia developed at 12.9 ± 9.2 months after robot-assisted laparoscopic radical prostatectomy and 15 ± 7.4 months in the normal groin group. Inguinal hernia-free ratios were significantly lower in the patent Processus vaginalis group than the normal groin group (P 

Thomas D. Clarnette - One of the best experts on this subject based on the ideXlab platform.

  • The development and closure of the Processus vaginalis
    Hernia, 1999
    Co-Authors: Thomas D. Clarnette, John M. Hutson
    Abstract:

    It is now well known that the failure of the Processus vaginalis (PV) to close off following descent of the testis not only accounts for nearly all inguinal hernias of childhood [Rothenberg et al, 1953], but also for other common congenital conditions of childhood such as scrotal hydroceles and encysted hydroceles of the cord. Despite the direct relationship of the PV to these conditions and its intimate association with the mechanism of testicular descent, surprisingly little is known about this important structure. It is not known, for instance, how the PV develops, what precise role it plays in testicular descent, what makes it close, or exactly when it closes. The purpose of this paper is to review the past and present literature on the PV, examining specifically its role in testicular descent, its postulated modes of development, and the mechanisms of its closure and disappearence following descent of the testis.

  • Shunts in Children Reveal the Natural History of Closure of the Processus vaginalis
    1998
    Co-Authors: Thomas D. Clarnette, John M. Hutson
    Abstract:

    Materialsand Methods:A retrospective review of all children undergoing insertion of ventriculoperitoneal shunts between 1985 and 1995 at the Royal Children’s Hospital was undertaken. In each case, the sex, the cause of hydrocephalus, the age at insertion of the shunt, and the subsequent development of an inguinal hernia or hydrocele was recorded. Results: There were 430 children in the study. An inguinal hernia developed in 15% of children after insertion of a ventriculoperitoneal shunt, and a hydrocele developed in an additional 6% of boys. lnguinal hernias were bilateral in 47% of boys and 27% of girls. The incidence of subsequent development of an inguinal hernia or hydrocele was closely related to the age of insertion of the ventriculoperitoneal shunt, being 30% during the last 8 weeks of gestation and the first few months of life, then falling quite sharply to reach about 10% at 1 year. Conclusions: The high occurrence of inguinal hernias and hydroceles after ventriculoperitoneal shunt insertion supports the role of raised intraabdominal pressure in the etiology of these conditions. It appears that raised intraabdominal pressure IS associated with an increased incidence of clinical hernias, but not with increased incidence of patency of the Processus vaginalis. The development of an inguinal hernia or hydrocele after insertion of a ventriculoperitoneal shunt can be used as an indirect marker of patency of the Processus vaginalis at the time of insertion of the shunt. From this, we propose that the Processus vaginalis remains patent in at least 30% of children in the first few months of life, after which time the patency rate appears to fall off quite sharply. J Pediatr Surg 33:473-416. Copyright o 1998 by W.B. Saunders Company.

  • Ventriculo-peritoneal shunts in children reveal the natural history of closure of the Processus vaginalis
    Journal of pediatric surgery, 1998
    Co-Authors: Thomas D. Clarnette, Simon K. L. Lam, John M. Hutson
    Abstract:

    Abstract Purpose: Little information is known about the natural history of closure of the Processus vaginalis. The authors studied children who had ventriculoperitoneal shunts to determine the natural history of closure of the Processus vaginalis and to better understand the role of intraabdominal pressure in the etiology of congenital inguinal hernia. Materials and Methods: A retrospective review of all children undergoing insertion of ventriculoperitoneal shunts between 1985 and 1995 at the Royal Children's Hospital was undertaken. In each case, the sex, the cause of hydrocephalus, the age at insertion of the shunt, and the subsequent development of an inguinal hernia or hydrocele was recorded. Results: There were 430 children in the study. An inguinal hernia developed in 15% of children after insertion of a ventriculoperitoneal shunt, and a hydrocele developed in an additional 6% of boys. Inguinal hernias were bilateral in 47% of boys and 27% of girls. The incidence of subsequent development of an inguinal hernia or hydrocele was closely related to the age of insertion of the ventriculoperitoneal shunt, being 30% during the last 8 weeks of gestation and the first few months of life, then falling quite sharply to reach about 10% at 1 year. Conclusions: The high occurrence of inguinal hernias and hydroceles after ventriculoperitoneal shunt insertion supports the role of raised intraabdominal pressure in the etiology of these conditions. It appears that raised intraabdominal pressure is associated with an increased incidence of clinical hernias, but not with increased incidence of patency of the Processus vaginalis. The development of an inguinal hernia or hydrocele after inserton of a ventriculoperitoneal shunt can be used as an indirect marker of patency of the Processus vaginalis at the time of insertion of the shunt. From this, we propose that the Processus vaginalis remains patent in at least 30% of children in the first few months of life, after which time the patency rate appears to fall off quite sharply.

  • is the ascending testis actually stationary normal elongation of the spermatic cord is prevented by a fibrous remnant of the Processus vaginalis
    Pediatric Surgery International, 1997
    Co-Authors: Thomas D. Clarnette, John M. Hutson
    Abstract:

    The Processus vaginalis (PV) forms as a peritoneal diverticulum within the gubernaculum testis to allow the testis to exit from the abdominal cavity. Failure of its closure leads to inguinal hernias and hydroceles. Ascending testis, which is likely to be an acquired form of undescended testis, may also be part of the spectrum of failure of regression of the PV At orchidopexy for cryptorchidism in older boys with a history of a scrotal testis in infancy, we find that the PV persists as a fibrous string, preventing normal elongation of the vas deferens and gonadal vessels with increasing size of the boy. We propose that the ascending testis is actually ‘stationary’, and is caused by persistence of a fibrous remnant of the PV Seen in this light, ascending testes are directly related to inguinal hernias.

  • Factors Affecting the Development of the Processus vaginalis in the Rat
    The Journal of urology, 1996
    Co-Authors: Thomas D. Clarnette, John M. Hutson, Spencer W. Beasley
    Abstract:

    AbstractPurpose: We examined the factors that influence development of the Processus vaginalis in the rat.Materials and Methods: Neonatal Sprague-Dawley rats 0 to 3 days old underwent distal or proximal gubernaculotomy, unilateral orchiectomy or proximal genitofemoral nerve transection. At ages 28 to 60 days the rats were sacrificed, position of the testis was noted and length of the Processus vaginalis measured.Results: There was no development of the Processus vaginalis after distal gubernaculotomy. Proximal gubernaculotomy enabled the Processus vaginalis to achieve a mean length similar to that of controls (p = 0.06) when the testis descended into the scrotum. Mean length of the Processus after proximal gubernaculotomy with an abdominal testis, surgical orchiectomy and torsion of the testis after proximal gubernaculotomy was similar (p = 0.9) but less than that of controls (p less than 0.05). Proximal division of the genitofemoral nerve produced variable results depending on how and when the surgical p...

Seung Hwan Lee - One of the best experts on this subject based on the ideXlab platform.

  • A Simple Procedure to Prevent Postoperative Inguinal Hernia after Robot-Assisted Laparoscopic Radical Prostatectomy: A Plugging Method of the Internal Inguinal Floor for Patients with Patent Processus vaginalis
    The Journal of urology, 2013
    Co-Authors: Dong Hoon Lee, Seung Hwan Lee, Kyo Chul Koo, Byung Ha Chung
    Abstract:

    Purpose: We introduce a simple procedure to prevent postoperative inguinal hernia after robot-assisted laparoscopic radical prostatectomy. We developed the inguinal hernia prevention procedure based on our prior study. Patent Processus vaginalis is an independent predictor of inguinal hernia after robot-assisted laparoscopic radical prostatectomy.Materials and Methods: We reviewed 74 patients (98 groins) with patent Processus vaginalis during robot-assisted laparoscopic radical prostatectomy between May 2007 and April 2013. Of these patients 38 (47 groins) did not undergo the inguinal hernia prevention procedure and 36 (51 groins) were treated with this procedure. For the inguinal hernia prevention the lateral side internal inguinal floor of the patent Processus vaginalis was incised and dissected along the spermatic cord. Hemostatic agents were plugged into the end of the dissected canal. After plugging, the internal inguinal floor was closed. We compared the incidence of postoperative inguinal hernia be...

  • patent Processus vaginalis in adults who underwent robot assisted laparoscopic radical prostatectomy predictive signs of postoperative inguinal hernia in the internal inguinal floor
    International Journal of Urology, 2013
    Co-Authors: Dong Hoon Lee, Ha Bum Jung, Mun Su Chung, Seung Hwan Lee, Byung Ha Chung
    Abstract:

    Objective:  To evaluate the risk for postoperative inguinal hernia according to the presence of patent Processus vaginalis in an adult population. Methods:  Medical records of 205 patients who underwent robot-assisted laparoscopic radical prostatectomy from May 2007 to November 2011 were reviewed. Age, prostate-specific antigen, prostate volume, body mass index, operative time and history of previous abdominal surgery were evaluated. The existence of patent Processus vaginalis was also evaluated for the development of postoperative inguinal hernia. Results:  Postoperative inguinal hernia occurred in 20 out of 410 (4.9%) groins (17/205 patients; 8.3%), and patent Processus vaginalis was observed in 49 out of 410 (11.9%) groins. In the normal groin group, inguinal hernia occurred in seven out of 361 (1.9%) groins. However, in the patent Processus vaginalis group, it occurred in 13 out of 49 (26.5%) groins. On univariate analysis using Cox proportional hazards model, age, body mass index, history of previous abdominal surgery and patent Processus vaginalis were significant risk factors. Among them, patent Processus vaginalis significantly increased the risk of postoperative inguinal hernia in multivariate analysis (hazard ratio 22.37). In the patent Processus vaginalis group, inguinal hernia developed at 12.9 ± 9.2 months after robot-assisted laparoscopic radical prostatectomy and 15 ± 7.4 months in the normal groin group. Inguinal hernia-free ratios were significantly lower in the patent Processus vaginalis group than the normal groin group (P < 0.001). Conclusions:  The existence of patent Processus vaginalis represents an important risk factor for postoperative inguinal hernia in adults. Urologists should consider the possibility of postoperative inguinal hernia when patent Processus vaginalis is observed during surgery.

  • Patent Processus vaginalis in adults who underwent robot-assisted laparoscopic radical prostatectomy: Predictive signs of postoperative inguinal hernia in the internal inguinal floor
    International journal of urology : official journal of the Japanese Urological Association, 2012
    Co-Authors: Dong Hoon Lee, Ha Bum Jung, Mun Su Chung, Seung Hwan Lee, Byung Ha Chung
    Abstract:

    Objective:  To evaluate the risk for postoperative inguinal hernia according to the presence of patent Processus vaginalis in an adult population. Methods:  Medical records of 205 patients who underwent robot-assisted laparoscopic radical prostatectomy from May 2007 to November 2011 were reviewed. Age, prostate-specific antigen, prostate volume, body mass index, operative time and history of previous abdominal surgery were evaluated. The existence of patent Processus vaginalis was also evaluated for the development of postoperative inguinal hernia. Results:  Postoperative inguinal hernia occurred in 20 out of 410 (4.9%) groins (17/205 patients; 8.3%), and patent Processus vaginalis was observed in 49 out of 410 (11.9%) groins. In the normal groin group, inguinal hernia occurred in seven out of 361 (1.9%) groins. However, in the patent Processus vaginalis group, it occurred in 13 out of 49 (26.5%) groins. On univariate analysis using Cox proportional hazards model, age, body mass index, history of previous abdominal surgery and patent Processus vaginalis were significant risk factors. Among them, patent Processus vaginalis significantly increased the risk of postoperative inguinal hernia in multivariate analysis (hazard ratio 22.37). In the patent Processus vaginalis group, inguinal hernia developed at 12.9 ± 9.2 months after robot-assisted laparoscopic radical prostatectomy and 15 ± 7.4 months in the normal groin group. Inguinal hernia-free ratios were significantly lower in the patent Processus vaginalis group than the normal groin group (P