DOI: http://dx.doi.org/10.18203/2349-2902.isj20192367

A study on association between inguinal hernia and benign prostatic hyperplasia

Suganth Sarvesh Parthiban, Balaji Durairaj

Abstract


Background: Inguinal hernia is the most common cause of abdomen wall hernias with multiple etiological risk factors. Benign prostatic hyperplasia (BPH) is the most important cause of bladder outlet obstruction in elderly males leading to chronic straining and difficulty in micturition, which can precipitate inguinal hernia. The occurrence of both inguinal hernia and BPH with lower urinary tract symptoms increases with age. Some studies show that their occurrence together is considered a chance co-existence rather than cause and effect. This study is aimed to find out whether BPH is a significant risk factor for developing inguinal hernia in males.

Methods: This study was conducted at a tertiary care hospital in Chennai. 126 males, aged 40 and above were selected according to inclusion criteria and were divided into two groups viz cases (with inguinal hernia) and controls (without inguinal hernia). IPSS scoring chart, prostate volume and uroflometric analysis were done for both groups and results were compared.

Results: IPSS scoring showed 22 cases (35%) and 22 controls (35%) had moderate to severe symptoms and no statistical significance. The mean prostate volume in cases was 22.5 g compared with 22.6 g among controls and was statistically insignificant. 11 cases (17%) and 13 controls (21%) had Qmax value less than 15 and the difference was statistically insignificant.

Conclusions: This study shows that, although both inguinal hernia and benign prostatic hyperplasia are seen with increased frequency in the aged male population, there is no statistically significant association between the two. Their occurrence together is considered a chance co-existence rather than cause and effect.


Keywords


BPH, Inguinal hernia, IPSS, Prostate volume, Peak flow rate

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References


Sangwan M, Sangwan V, Garg M, Mahendirutta P, Garg U. Abdominal wall hernia in a rural population in India-Is spectrum changing? Open J Epidemiol. 2013;3:135-8.

Ashindoitiang JA, Ibrahim NA, Akinlolu OO. Risk factors for inguinal hernia in adult male Nigerians: A case control study. Int J Surg. Elsevier Ltd. 2012;10(7):364-7.

Taylor BC, Wilt TJ, Fink HA, Lambert LC, Marshall LM, Hoffman AR, et al. Prevalence, severity and health correlates of lower urinary tract symptoms among older men. The MrOS study. Urol. 2006;68(4):804-9.

Tatar IG, Ergun O, Celtikci P, Birgi E, Hekimoglu B. Value of prostate gland volume measurement by transrectal US in prediction of the severity of lower urinary tract symptoms. Med Ultrason. 2014;16(4):315-8.

Bawa AS, Batra RK, Singh R. Management of inguinal hernia with benign prostatic hyperplasia: simultaneous inguinal hernioplasty with transurethral resection of prostate. Int Urol Nephrol. 2003;35(4):503-6.

Liao CH, Chung SD, Kuo HC. Measurement of ipss-storage and IPSS-empty subscores could help to differentiate bladder related and urethral-related conditions in men with luts for initial medical treatment. Int Urogynecol J Pelvic Floor Dysfunct. 2011.

Kayalvizhi I, Bhoria S, Khanagwal VP, Narayan RK. Morphological study of prostate in different age groups of Indian population. J Morphol Sci. 2017;34(1):40–3.

Berges R, Oelke M. Age-stratified normal values for prostate volume, PSA, maximum urinary flow rate , IPSS , and other LUTS/BPH indicators in the German male community-dwelling population aged 50 years or older. World J Urol. 2011;29(2):171-8.

Loeb S, Kettermann A, Carter HB, Ferrucci L, Metter EJ, Walsh PC. Prostate Volume Changes Over Time: Results From the Baltimore Longitudinal Study of Aging. J Urol. 2009;182(4):1458-62.

Mor A, Sharma SM, Mukherjee S, Jindal R. A clinico pathological study and management of benign enlargement of prostate. Int Surg J. 2018;5(4):1275–80.

Zhang SJ, Qian HN, Zhao Y, Sun K, Wang HQ, Liang GQ, et al. Relationship between age and prostate size. Asian J Androl. 2013;15(1):116-20.

Sentürk AB, Ekici M, Sahiner IT, Tas T, Cakiroglu B. Relationship between lower urinary tract symptoms and inguinal hernia. Arch Ital di Urol Androl organo Uff [di] Soc Ital di Ecogr Urol e Nefrol. 2016;88(4):262–5.

Sundaram D, Sankaran PK, Raghunath G, Vijayalakshmi S. Correlation of Prostate Gland Size and Uroflowmetry in Patients with Lower Urinary Tract Symptoms. J Clin Diagn Res. 2017;11(5):1-4.

Sivasankaran MV, Pham T, Pharm D, Divino CM. Incidence and risk factors for urinary retention following laparoscopic inguinal hernia repair. Am J Surg. Elsevier Inc. 2014;207(2):288-92.

Patel JA, Kaufman AS, Howard RS, Rodriguez CJ, Jessie EM. Risk factors for urinary retention after laparoscopic inguinal hernia repairs. Surg Endosc Other Interv Tech. Springer US. 2015;29(11):3140–5.

Çimentepe E, Inan A, Ünsal A, Dener C. Combined transurethral resection of prostate and inguinal mesh hernioplasty. Int J Clin Pract. 2006; 60(2):167-9.

Othman I, Abdel-Maguid AF. Combined transurethral prostatectomy and inguinal hernioplasty. Hernia. 2010;14(2):149–53.

Khiari R, Ghozzi S, Hmidi M, Khouni H, Hammami A, Ktari M, et al. Association of benign prostatic hyperplasia and hernia inguinale.Tunis Med. 2006;84(12):790-3.