Future prostate cancer surgery

[DrBrown]

Dear Scott.
I would advise you to start with a pure tissue repair.
There is a small chance that it would fail. If it does a second pure tissue repair can be performed.
Regards.
Bill Brown MD

[Scott]

dr Brown, what happens if you have Crohn’s disease get a tissue repair and it fails
To hold, what would be the next step to repair hernia
Can you get multiple tissue repairs or would it then be necessary to get mesh

[DrBrown]

With Crohn’s disease I would advise against a mesh repair because of the increased risk for infection and autoimmune problems.
If you will need prostate surgery, then avoid laparoscopic hernia repair because the mesh can make it more difficult.
Regards.
Bill Brown MD

[Alephy]

This is an excellent question: I guess if shouldice fails one can only use another technique or mesh?

[Scott]

I believe in my case I have a higher chance of reoccurrence do to having Crohn’s disease and enlarged prostate
The reason in my mind my thinking is if I go with shouldice technique and it fails, all that suturing and cutting of cremaster muscle would be for nothing, can you do a shouldice technique on someone again if it fails the first time
Another words a repeat shouldice technique

[Scott]

Thanx for your reply, this might be a silly question but can you tell me which type
Mesh repair using open technique would cause the least amount of urological problems
For prostate issues
Thanx

[Good intentions]

Hello Scott. @tigerpawn

I was referred to a urologist when I was having mesh problems and he made a comment about how they had to cut through the mesh to do prostate surgery, sometimes. He made it sound like mesh made his job more difficult. I would see or talk to a urologist to get their opinions.

As far as choosing a repair procedure, I say this often, but if a suture repair fails you can always get mesh afterward. The odds of problems from mesh are higher, I think, and much more difficult to deal with.

I don’t think the Shouldice or Desarda are deep enough to interfere with prostate surgery, since they are focused on the groin area alone. Laparoscopic mesh implants today though, are much larger than the actual hernia defect. They try to cover as much area, all the way to the midline, as they can. They can get in the way,as my urologist said. But an open mesh repair might not, depending on what type it was, onlay, or Lichtenstein, or Kugel, or pre-peritoneal, or Onstep, or PHS. There are many many types of mesh repair. You really have to distinguish between them, you can’t group them all together as “mesh”. Especially for your question.

Good luck.