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Hernia repair...or not?

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Posted 6/28/2013 2:26 PM (GMT 0)
Hi guys:

Back home in LA, doing my pre-op clearances and doctor visits - RP surgery is scheduled for this coming Monday morning.

Yesterday I saw the doc who is scheduled to do the additional hernia repair. After checking me out and reviewing my case, he advised me not to go ahead with the repair. He said that he is not a fan of piggyback surgeries - he would do it if I wanted, but if the RP doesn't go 100% perfectly, he will elect not to go ahead. He suggested I wait, and return for a follow-up 4 weeks or so after my RP to discuss the hernia further.

I told him I was not happy with the notion of going back for an additional surgery (and dealing with the associated recovery time) so soon after the RP. His response was that I could have the hernia repair anytime I wanted - this year, next year - or we could just watch it and I could have the repair done whenever I felt bothered by it. So it is up to me - he gave me his cell number and said to let him know one way or the other this weekend.

So I'm throwing this out to the group - especially to the guys who have had the hernia repair done at the same time as the RP. What do you think I should do? Have it done now and deal with all the recovery at once - or wait, and know I will be having another surgery (under general anesthesia) at some point in the future?

On a lighter note...we're having great weather here in LA, and I'm enjoying my last few days of freedom from pee pee pads! Feeling good, and ready to give my PCa a swift kick in the pants on Monday...

Thanks in advance...
Posted 6/28/2013 2:45 PM (GMT 0)
Doug,
I had a hernia repair done long past my RP. I can see the pros and cons. Pro: get it all out of the way .. one time on pain meds, etc. Con: that is a lot of recovery. Not to worry you, but I found the hernia repair to be quite painful for a few days afterward. I needed Vicodin for a few days. Having said that, getting my hernia fixed was a great decision. It was a big inguinal hernia and now that area is flat and strong. I work out without any concerns. There is no discomfort at all. I am glad I did it. Good luck with your decision.
SC
Posted 6/28/2013 2:53 PM (GMT 0)
I must say that returning to full steam was harder for me after fixing the hernia than it was recovering from mister roboto.
Posted 6/28/2013 2:59 PM (GMT 0)
I had a hernia repair last year. I didn't have the RP, I did IMRT so it's a little different.

What my surgeon told me was very similar to yours - largely up to you. My doc stressed that the key factor was really my discomfort and pain level. If you're in enough pain now, you might want to get it out of the way but given the PC you might have more important health issues to resolve first.

Understand your desire to have both done at the same time but it could be just one too many things to do at once.

As far as recovery time from the Hernia - I was only off my feet and on pain meds for 3 days and had lifting restrictions for a couple of months (no more that 5 pounds the first month, 20 the second - don't know if that is standard but that's what my doc said). I have an office job and could do some work from home so I was doing part time work about 6 days after surgery and back to my regular work schedule in about 2 weeks.

It's heck of a choice with no clear cut answer. Wish I could be more helpful.

Here's hoping all goes well with the RP. Enjoy your freedom till then.

All the best,
Andrew
Posted 6/28/2013 3:25 PM (GMT 0)
I had a TURP operation (Trans Urethral Resection of Prostate - not a prostatectomy, but a kind of prostate surgery) about two years ago along with an inguinal hernia repair at the same time. Incidentally, the hernia in my case wasn't even discovered until my pre-op physical to get ready for the TURP. My surgeon then made available to me the choice of whether or not to take care of the hernia during the TURP operation.

In contrast to your case, my surgeon actually encouraged me to get the hernia fixed during the TURP surgery ("might as well get it all done at once"). So I did.

Yes, recovery would be a bit longer and more complicated than opting for two separate surgeries, but if there is no medical reason why doing both at the same time is inadvisable, then apparently the option to do so is there if you want it.

All the posts so far have given you good advice. All I would add is to start a pro-and-con chart for doing both at the same operation, fill it up with the various options, study it, and make your decision.

Good luck.
Posted 6/28/2013 3:28 PM (GMT 0)
I'd be tempted to do both at the same time if it could be made to work. Go heavy on the stool softeners since I'd be sure to get into the pain meds and the good ones tend to be constipating which would be the last thing I'd need. That's not advice -- just a glimpse into my peculiar brain.
Posted 6/28/2013 3:48 PM (GMT 0)
I have no insight/advice on the hernia repair question, but want to wish you all the best on the RP!

-Gedman
Posted 6/28/2013 4:01 PM (GMT 0)
Morning,

I had a double hernia repair done the same time as my open Surgery. I wanted one recovery and not two.

All in all a good experience... My only reservation in telling you to "go for it" is that when I did have pain I could not determine what surgery it was from.

Best of luck.

Posted 6/28/2013 5:41 PM (GMT 0)
Laparoscopic RP increases the risk of hernia. 5.3% of men who had minimally invasive RP had an incisional hernia that required repair:

Risk of Incisional Hernia after Minimally Invasive and open Radical Prostatectomy.

Given the increased risk of damage to the abdominal wall, it might be prudent to repair the existing damage.

- Allen
Posted 6/28/2013 6:52 PM (GMT 0)
My husband had hernia repair done at same time, in fact they said the hernia repair took twice as long as robotic surgery. No difficulties in recoveries. How would one know if the additional caused more pain anyway? Why would one want to go under again a month or 6 weeks later?
Posted 6/28/2013 10:38 PM (GMT 0)
Thank you all so much for your responses. After thinking it over and consulting with my urosurgeon (who had already spoken to the general surgeon), I decided to go ahead and have the hernia repair. For me, it will be better to just have one set of surgeries to recover from - I don't want to go through this again, even a year from now, if I don't have to. Everyone's advice much appreciated...!

All my pre-op testing and appointments are done - had my last pelvic floor rehab session as well - now I'm as ready as I'll ever be. Think good thoughts, everyone..

DougInLA
Posted 6/29/2013 10:46 AM (GMT 0)
Doug, I had the 2 procedures done together and am very glad I did. Once the robotic surgery was complete, the second doc, using his own laporoscopic device, went in using the same incision points and took about 20 minutes to sew up my hernia.

One recovery time vs. two is, IMHO, worth it.

Good luck Monday.
Posted 6/29/2013 4:23 PM (GMT 0)
Doug - glad you were able to make a decision. That's often the hardest part

Here's hoping it all goes according to plan.

Keep us updated on your progress.

Andrew
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