What question did this study set out to answer?

To evaluate the impact of surgical approaches on the incidence of inguinal hernias following radical prostatectomy.

January 22, 2026Journal of Minimal Access Surgery1 citationsOpen Access

De novo inguinal hernia after radical prostatectomy: Does the access make some difference? – A systematic review and meta-analysis

MGMiéllio Melo GaldinoFaculdade de Medicina do ABC AHAlexandre Kyoshi Hidaka MMMatheus Cardoso MorroneCentro Universitário Cesmac

Key Points

To evaluate the impact of surgical approaches on the incidence of inguinal hernias following radical prostatectomy.
Conducted a systematic review and meta-analysis following PRISMA guidelines.
Reviewed 670 studies to identify eligible research on hernia incidence post-prostatectomy.
Compared incidences of inguinal hernias between Retzius-sparing and conventional surgical techniques.
Retzius-sparing robot-assisted radical prostatectomy shows a significantly lower incidence of inguinal hernias compared to conventional methods.
The odds ratio for hernia incidence was 0.31 with a confidence interval of 0.18–0.55; P < 0.001.
Preserving the Retzius space may reduce the risk of postoperative inguinal hernias, while reconstructive measures do not enhance this protection.

Abstract

Abstract Prostate cancer is one of the most prevalent neoplasms among men, and radical prostatectomy is a common treatment. While urinary incontinence and erectile dysfunction are frequently discussed postoperative complications, the incidence of inguinal hernias (IHs) has received less attention. Retzius-sparing robot-assisted radical prostatectomy (RS-RALP) has emerged as a technique that may reduce the risk of IH compared to conventional approaches (C-RALP). We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate whether different surgical approaches influence the incidence of IHs. From 670 initially identified studies, four met the inclusion criteria. The meta-analysis showed that RS-RALP was associated with a significantly lower incidence of IH compared to C-RALP (odds ratio = 0.31; confidence interval = 0.18–0.55; P < 0.001). Preservation of the Retzius space appears to reduce the risk of postoperative IH, whereas reconstructive measures within this space do not seem to offer additional protection.

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