umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Incidence of groin hernia repair after radical prostatectomy: a population-based nationwide study
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
2014 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 259, no 6, 1223-1227 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To assess the incidence of groin hernia repair after radical prostatectomy for prostate cancer compared with the incidence in a control population without prostate cancer in a nationwide, population-based study.

Background: Recent reports indicate an increase in the incidence of groin hernia repair after radical prostatectomy. Inadequate knowledge of the incidence of groin hernia in the general population makes this information hard to interpret.

Methods: Information was retrieved from the Prostate Cancer Database (PCBaSe) and Swedish Hernia Register for events between 1998 and 2010. The incidence of groin hernia surgery was calculated for a group of men treated with radical prostatectomy (open and minimally invasive) and for a group treated with radiation therapy, and these were compared with the incidence in a control cohort of men matched for age and county of residence. Multivariate analysis was used to assess the hazard ratio (HR) of groin hernia repair according to age, tumor risk category, and Charlson Comorbidity Index.

Results: A total of 28,608 cases and 105,422 controls were included in the study. Men treated with radical prostatectomy and radiation therapy had a significantly higher incidence of groin hernia repair than the control cohort: HR: 3.95 (95% confidence interval: 3.70-4.21) for retropubic prostatectomy, HR: 3.37 (95% confidence interval: 2.95-3.87) for minimally invasive prostatectomy, and HR: 1.84 (95% confidence interval: 1.66-2.04) for radiation therapy.

Conclusions: An almost 4-fold increase in groin hernia repair was observed after radical prostatectomy compared with controls, and men who received radiation therapy had an almost 2-fold increase in incidence. As well as postoperative changes in the abdominal wall, increased vigilance for groin hernia seems to be important for the increased incidence of groin hernia repair seen after radical prostatectomy or radiation therapy for prostate cancer.

Place, publisher, year, edition, pages
2014. Vol. 259, no 6, 1223-1227 p.
Keyword [en]
groin hernia, nationwide register, population-based, radiation therapy, radical prostatectomy
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-82944DOI: 10.1097/SLA.0b013e3182975c88ISI: 000337296700037OAI: oai:DiVA.org:umu-82944DiVA: diva2:664030
Available from: 2013-11-13 Created: 2013-11-13 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Mortality and morbidity after groin hernia surgery: the role of nationwide registers in finding and analysing rare outcomes
Open this publication in new window or tab >>Mortality and morbidity after groin hernia surgery: the role of nationwide registers in finding and analysing rare outcomes
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Groin hernia surgery is one of the most common surgical procedures world-wide. Although mainly uncomplicated, the large volume of these operations makes it important to consider severe postoperative complications. The Swedish Hernia Register (SHR) started in 1992 and has grown to include more than 95% of all groin hernia operations performed in Sweden empowering it to be merged with other registers in population-based studies. The aim of this thesis is to merge SHR with other nation-wide registers to analyse postoperative mortality, cardiovascular morbidity, surgical hazards, as well as to study the influence of prostatectomy upon the risk for subsequent groin hernia surgery.

Methods: SHR was interlinked with the Cause of Death Register to find standardised mortality ratio, the National Prostate Cancer Register to find incidence of groin hernia surgery after prostatectomy compared to a control group and with the National Patient Register to find morbidity within 30 days of groin hernia surgery. In paper II, medical records of deceased patients were retrieved and scrutinised.

Results: Elective groin hernia surgery was found to be a low risk procedure even for elderly patients. The mortality risk within 30 days of emergency surgery was raised sevenfold compared to that of the background population. Women had a threefold increased risk of postoperative mortality compared to men. Patients with bowel obstruction, not examined for groin hernia in the emergency room, were subject to more radiological examinations and were operated significantly later than patents with a clinical diagnosis of groin hernia. Compared to men, significantly fewer women were examined for groin hernia in the emergency ward, 61% vs. 78%, (P=0.04). High age, co-morbidity, emergency operation, and regional anaesthesia were risk factors for cardiovascular events. Compared to open anterior mesh repair, all other methods were associated with increased risk of surgical complication, intra-operatively or postoperatively. A threefold increase in groin hernia surgery was seen after radical prostatectomy, conventional as well as minimally invasive.

Discussion: Women are significantly overrepresented concerning mortality after groin hernia surgery. This thesis shows the importance of nation-based registers in the analysis of infrequent phenomena in surgical care.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2013. 54 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1614
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-82975 (URN)978-91-7459-755-4 (ISBN)
Public defence
2013-12-13, Tandläkarhögskolan, sal B, 9 tr, Norrlands universitetssjukhus, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2013-11-19 Created: 2013-11-14 Last updated: 2013-11-19Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Authority records BETA

Nilsson, HannaStattin, PärNordin, Pär

Search in DiVA

By author/editor
Nilsson, HannaStattin, PärNordin, Pär
By organisation
SurgeryUrology and Andrology
In the same journal
Annals of Surgery
Surgery

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 108 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf