Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Hernia Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
In short
Groin hernias and prostate trouble often turn up in the same man, at the same age. One does not cause the other. But they push on each other, and the order in which they are dealt with matters.
This page is about that order. It is not about prostate disease itself, which a urologist looks after.
When the prostate grows, the bladder has to push harder to empty. Many men bear down without noticing, every time they pass urine, many times a day.
Each push raises the pressure inside the belly. That pressure presses on the weak spot in the groin. Over months it can make a hernia grow, and after surgery it presses on the fresh repair.
It is the same problem as a long cough or hard stools. The load comes from inside, and it is repeated.
This does not usually mean a long delay. For most men it is a few weeks. It is worth it, because a repair that is strained every day is a repair more likely to fail.
How prostate symptoms change the hernia plan
| Your situation | What usually happens first | Why |
|---|---|---|
| No trouble passing urine | Hernia repair as planned | There is no extra strain on the repair |
| Mild symptoms, good flow | Repair, with a bladder plan for the first night | Retention is possible but unlikely |
| Straining, weak stream, getting up at night | Urology check and a tablet, then repair | Less straining protects the repair |
| Prostate operation already advised | Agree the order with the urologist | The two operations work in nearby spaces |
| Raised PSA under review | Finish the prostate tests first | The result may change which operation comes first |
Getting up at night and straining to pass urine as well as a groin bulge? Bring both to the same visit.
A small number of men cannot pass urine for some hours after a groin hernia repair. The anaesthetic, pain and lying flat all play a part. A large prostate makes it more likely.
If it happens, a thin tube is passed into the bladder to drain it. Most men pass urine normally once it is removed. It is uncomfortable, but it is not a sign that anything has gone wrong with the repair.
Knowing about your prostate beforehand helps. The anaesthetist can plan for it, and you can be told in advance what to expect.
Many hernia repairs today place the mesh behind the muscles, in the space in front of the bladder. A robotic prostate operation for cancer works in that same space.
A mesh there does not rule out a later prostate operation. But it can make it harder. So if a raised PSA is being looked into, or a prostate operation is already likely, say so before your hernia repair. The approach can be chosen with that in mind.
The other way round matters too. If you have already had prostate surgery, the hernia repair is planned around the scar it left.
Signs that should not wait
Bring any prostate scan, your latest PSA result, and the names of the tablets you take for your urine. Say how often you get up at night to pass urine.
Dr Shah does not treat the prostate himself. Where it is needed, he plans the hernia repair together with a urology colleague, so you get one plan rather than two separate ones.
It does not cause one directly. Straining to pass urine for years raises the pressure in the belly, and that pressure pushes on any weak spot in the groin.
If you strain hard to pass urine, yes, in most cases. A urologist checks the flow first, often starts a tablet, and the hernia repair follows.
Anaesthesia and pain can stop the bladder emptying for a few hours. It is more likely with a large prostate. A short-term catheter usually settles it.
It can. A mesh placed behind the muscles sits close to where a robotic prostate operation works. Tell both surgeons if either operation is likely.
Sometimes, but it is not the usual plan. Most men do better with the prostate settled first and the hernia repaired as a separate, planned operation.
The main page on this site is robotic hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Shah's Gastro, Cancer & Robotic Surgery Centre
Apollo Hospital, Bhat, Gandhinagar
Gota OPD, Ahmedabad
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