Optimizing the detection of subclinical inguinal hernias in men undergoing open radical retropubic prostatectomy

Tracy Marien, Bachir Taouli, Shpetim Telegrafi, James Babb, Herbert Lepor

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective: To evaluate the role of magnetic resonance imaging (MRI) and up-standing ultrasonography (USUS) for the detection of inguinal hernias (IHs) before open radical retropubic prostatectomy (ORRP) and to assess factors associated with the presence of IHs in these men. Patients and Methods From 1 July 2007 to 1 February 2009, 164 men underwent preoperative evaluation for ORRP by one surgeon. Of these men 113 (69%) were evaluated for IHs by physical examination (PE), USUS and MRI. In all 226 groins were examined. Any IH diagnosed by any method was considered a true positive. The sensitivity, negative predictive value (NPV), and concordance were calculated for the three diagnostic methods. Possible predictive factors of IHs were evaluated. Results: Of the 226 groins evaluated, 72 (32%) IHs were diagnosed. USUS had the greatest sensitivity (69.4%) and the highest NPV (87.5%). MRI had fair agreement with PE and USUS, while USUS and PE had moderate agreement with each other. No factor was associated with an increased likelihood of preoperative diagnosis of IH. Conclusion S This study was limited by the lack of a reference standard to diagnose IH. USUS was the most sensitive method for the detection of IH. We recommend that all men undergoing ORRP should be evaluated for IHs by PE and at least one imaging method and that IHs be repaired at the time of ORRP, obviating the need for a second surgical procedure.

Original languageEnglish
Pages (from-to)1468-1472
Number of pages5
JournalBJU International
Issue number10
StatePublished - Nov 2010
Externally publishedYes


  • inguinal hernia
  • magnetic resonance imaging
  • prostate cancer
  • radical prostatectomy
  • ultrasonography


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