{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:31:11Z","timestamp":1786728671392,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Prostate cancer is one of the most prevalent neoplasms among men, and radical prostatectomy is a common treatment. While urinary incontinence and erectile dysfunction are frequently discussed postoperative complications, the incidence of inguinal hernias (IHs) has received less attention. Retzius-sparing robot-assisted radical prostatectomy (RS-RALP) has emerged as a technique that may reduce the risk of IH compared to conventional approaches (C-RALP). We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate whether different surgical approaches influence the incidence of IHs. From 670 initially identified studies, four met the inclusion criteria. The meta-analysis showed that RS-RALP was associated with a significantly lower incidence of IH compared to C-RALP (odds ratio = 0.31; confidence interval = 0.18\u20130.55;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). Preservation of the Retzius space appears to reduce the risk of postoperative IH, whereas reconstructive measures within this space do not seem to offer additional protection.\n                  <\/jats:p>","DOI":"10.4103\/jmas.jmas_295_24","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T14:00:18Z","timestamp":1768917618000},"page":"1-6","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["De novo inguinal hernia after radical prostatectomy: Does the access make some difference? \u2013 A systematic review and meta-analysis"],"prefix":"10.4103","volume":"22","author":[{"given":"Mi\u00e9llio Melo","family":"Galdino","sequence":"first","affiliation":[{"name":"Department of Urology, Centro Universit\u00e1rio FMABC, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Kyoshi","family":"Hidaka","sequence":"additional","affiliation":[{"name":"Department of Urology, Centro Universit\u00e1rio FMABC, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Cardoso","family":"Morrone","sequence":"additional","affiliation":[{"name":"Department of Urology, Centro Universit\u00e1rio FMABC, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Henrique Franco","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Urology, Centro Universit\u00e1rio FMABC, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney","family":"Glina","sequence":"additional","affiliation":[{"name":"Department of Urology, Centro Universit\u00e1rio FMABC, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Dell\u2019Oglio","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Galfano","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Tobias","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Urology, Centro Universit\u00e1rio FMABC, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"R2-20260121","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1002\/ijc.29538","article-title":"Prevalence of incidental prostate cancer:A systematic review of autopsy studies","volume":"137","author":"Bell","year":"2015","journal-title":"Int J Cancer"},{"key":"R3-20260121","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1111\/j.1442-2042.2009.02370.x","article-title":"Simple prophylactic procedure of inguinal hernia after radical retropubic prostatectomy:Isolation of the spermatic cord","volume":"16","author":"Sakai","year":"2009","journal-title":"Int J Urol"},{"key":"R4-20260121","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.urology.2010.04.019","article-title":"Predictors of inguinal hernia after radical prostatectomy","volume":"77","author":"Rabbani","year":"2011","journal-title":"Urology"},{"key":"R5-20260121","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.urology.2006.09.043","article-title":"Postoperative inguinal hernia after radical prostatectomy for prostate cancer","volume":"69","author":"Abe","year":"2007","journal-title":"Urology"},{"key":"R6-20260121","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/s10029-017-1588-9","article-title":"Anatomical Retzius-space preservation is associated with lower incidence of postoperative inguinal hernia development after robot-assisted radical prostatectomy","volume":"21","author":"Chang","year":"2017","journal-title":"Hernia"},{"key":"R7-20260121","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1089\/end.2020.0463","article-title":"Pelvic anatomical features after retzius-sparing robot-assisted radical prostatectomy intended for early recovery of urinary symptoms","volume":"35","author":"Ota","year":"2021","journal-title":"J Endourol"},{"key":"R8-20260121","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.euros.2020.09.004","article-title":"Impact of Retzius-sparing versus standard robotic-assisted radical prostatectomy on penile shortening, Peyronie's disease, and inguinal hernia sequelae","volume":"22","author":"Kowalczyk","year":"2020","journal-title":"Eur Urol Open Sci"},{"key":"R9-20260121","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.prnil.2023.12.003","article-title":"A novel anterior approach that involves Retzius space development between the umbilical ligaments is associated with a lower incidence of postoperative inguinal hernia in robotic radical prostatectomy","volume":"12","author":"Washino","year":"2024","journal-title":"Prostate Int"},{"key":"R10-20260121","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/JU.0000000000000313","article-title":"Incidence of inguinal hernia after radical prostatectomy:A systematic review and meta-analysis","volume":"203","author":"Alder","year":"2020","journal-title":"J Urol"},{"key":"R11-20260121","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.eururo.2010.08.006","article-title":"Inguinal hernia after radical prostatectomy for prostate cancer:Results from a randomized setting and a nonrandomized setting","volume":"58","author":"Stranne","year":"2010","journal-title":"Eur Urol"},{"key":"R12-20260121","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1159\/000448339","article-title":"Incidence, risk factors and a novel prevention technique for inguinal hernia after robot-assisted radical prostatectomy","volume":"98","author":"Shimbo","year":"2017","journal-title":"Urol Int"},{"key":"R13-20260121","doi-asserted-by":"crossref","first-page":"738421","DOI":"10.3389\/fsurg.2021.738421","article-title":"Comparison of retzius-sparing robot-assisted radical prostatectomy versus conventional robot-assisted radical prostatectomy:An up-to-date meta-analysis","volume":"8","author":"Xu","year":"2021","journal-title":"Front Surg"},{"key":"R14-20260121","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.eururo.2010.06.008","article-title":"A new anatomic approach for robot-assisted laparoscopic prostatectomy:A feasibility study for completely intrafascial surgery","volume":"58","author":"Galfano","year":"2010","journal-title":"Eur Urol"},{"key":"R15-20260121","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.eururo.2013.06.046","article-title":"Beyond the learning curve of the Retzius-sparing approach for robot-assisted laparoscopic radical prostatectomy:Oncologic and functional results of the first 200 patients with \u22651 year of follow-up","volume":"64","author":"Galfano","year":"2013","journal-title":"Eur Urol"},{"key":"R16-20260121","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/bju.12705","article-title":"Retzius-sparing robot-assisted laparoscopic radical prostatectomy:Combining the best of retropubic and perineal approaches","volume":"114","author":"Lim","year":"2014","journal-title":"BJU Int"},{"key":"R17-20260121","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/j.urology.2007.07.069","article-title":"Inguinal hernia after radical perineal prostatectomy:Comparison with the retropubic approach","volume":"70","author":"Matsubara","year":"2007","journal-title":"Urology"},{"key":"R18-20260121","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1159\/000082706","article-title":"Lower incidence of inguinal hernia:Minilaparotomy radical retropubic prostatectomy compared with conventional technique. A preliminary report","volume":"74","author":"Nomura","year":"2005","journal-title":"Urol Int"},{"key":"R19-20260121","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1111\/j.1442-2042.2009.02298.x","article-title":"Incidence of inguinal hernia after radical retropubic, perineal and laparoscopic prostatectomy","volume":"16","author":"Hicks","year":"2009","journal-title":"Int J Urol"},{"key":"R20-20260121","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s11701-017-0768-z","article-title":"Retzius space reconstruction following transperitoneal laparoscopic robot-assisted radical prostatectomy:Does it have any added value?","volume":"12","author":"Abu-Ghanem","year":"2018","journal-title":"J Robot Surg"},{"key":"R21-20260121","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1093\/aje\/kwm011","article-title":"Risk factors for inguinal hernia among adults in the US population","volume":"165","author":"Ruhl","year":"2007","journal-title":"Am J Epidemiol"},{"key":"R22-20260121","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.surg.2014.09.029","article-title":"Risk factors for inguinal hernia in middle-aged and elderly men:Results from the Rotterdam study","volume":"157","author":"de Goede","year":"2015","journal-title":"Surgery"},{"key":"R23-20260121","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1097\/SLA.0b013e31816b4399","article-title":"Body mass index and groin hernia:A 34-year follow-up study in Swedish men","volume":"247","author":"Rosemar","year":"2008","journal-title":"Ann Surg"},{"key":"R24-20260121","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1097\/JS9.0000000000000217","article-title":"The global, regional, and national burden and its trends of inguinal, femoral, and abdominal hernia from 1990 to 2019:Findings from the 2019 Global Burden of Disease Study \u2013A cross-sectional study","volume":"109","author":"Ma","year":"2023","journal-title":"Int J Surg"},{"key":"R25-20260121","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1007\/s00261-017-1270-9","article-title":"Preoperative CT findings of subclinical hernia can predict for postoperative inguinal hernia following robot-assisted laparoscopic radical prostatectomy","volume":"43","author":"Sim","year":"2018","journal-title":"Abdom Radiol (NY)"},{"key":"R26-20260121","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1442-2042.2012.03118.x","article-title":"Patent processus vaginalis in adults undergoing robot-assisted laparoscopic radical prostatectomy:Predictive signs of postoperative inguinal hernia in the internal inguinal perioperative period","volume":"20","author":"Lee","year":"2013","journal-title":"Int J Urol"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_295_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:30:12Z","timestamp":1786725012000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_295_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_295_24","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]},"assertion":[{"value":"2024-10-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}