Giorgio Maria Paul Graziano1, Carnazzo Santo2, Samperisi Luigi2 and Antonino Graziano3*
1University of Catania Medical School, Italy
2Reseach University of Catania, Azienda, Policlinico, Italy
3University of Catania, Azienda, Policlinico, Department of Sciences Medical Surgery and advanced technologies “G Ingrassia”, Italy
Received: 01 March, 2016; Accepted: 28 March, 2016; Published: 30 March, 2016
Antonino Graziano, Department of Sciences Medical Surgery and advanced technologies “G Ingrassia”, via S Sofia 86, Catania cap, 95125, Italy, E-mail:
Paul Graziano GM, Santo C, Luigi S, Graziano A (2016) One Time Surgery in Contemporary Diseases of the Abdominal Wall and Pelvis in the Elderly. J Surg Surgical Res 2(1): 018-020.10.17352/2455-2968.000024
© 2015 Paul Graziano GM et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Hernioplasty adenomectomy prostatic
Introduction: The diseases most frequently found in the elderly are E.I. (inguinal hernia)* and BPH. (Prostatic hypertrophy non-neoplastic)*. The latter causes an effect on the abdominal wall to the increase in abdominal pressure from cervical-urethral obstruction, leading to the onset of the inguinal hernia pathology due to abdominal pressure which is higher, the greater as the residual bladder urine. The purpose of the study is to provide information on the surgical strategy and on timing in the presence of the simultaneous two diseases.
Material and Method: Patients observed and joint treated were divided into two subgroups A (patients without) and B (patients with prosthetic implantation), with a mean age of 74 years. These patients accounted for 23% of the cases handled by hernioplasty and 49% of treated cases of BPH. The surgical treatment performed for joint pathologies in the two groups was that of a Pfannestiel single super-pubic incision extending on the projection of the inguinal ligament. In a first stage is performed a prostatic adeno-myomectomy sec Frayer, and subsequently an hernioplasty (prosthetic and do not).
Results: The complications (seroma, hematoma) represented 10.6% of group A patients. In group B patients’ complications attested to only 6% of cases, without a significant increase in complications or therapeutic failure, or a prolongation of hospital stay which was an average of 4 days and of 2 days in group A and B respectively. Early recurrent hernia, episodes that usually occur in the immediate postoperative period (prosthesis mobilization, throttling of the spermatic cord, etc.), we observe only 1% in group B, while present in 3% of patients in group A without affixing the prosthetic material. Finally the follow-up, implemented for a period of 24 -36 months to two groups, was sufficiently adequate for the purposes of a detection of possible late complications or relapses.
Discussion: The affixing of the prosthesis thanks to the continuous evolution of materials and improved surgical technique favors the consolidation of early hernioplasty and the further reduction of the relapse rate. The simultaneous treatment of the two diseases in terms of satisfaction in patients treated has produced excellent results. Patients with only one operating session are not exposed to additional risks both anesthesia, and surgical, still burdened by complications
Conclusions: The treatment of joint diseases EI ((inguinal hernia) and BPH (prostatic hypertrophy non-neoplastic) meets a great liking to the patient, for the adoption of a single analgesia to allow the implementation of both interventions in same day. Anatomical incision detects any non-clinically significant hernias, or unmask.
The most frequent pathologies in patients in geriatric age are the EI (inquinal hernia)* and l ‘BPH (benign prostatic hypertr3ophy)*. Codest diseases reach the highest incidence after age 60  and in that decade of age do it takes a high hit statistical Office of the contemporaneity of the two diseases [2,3]. The feature pathophysiology is characterized by the association of the two diseases caused by a part to increased endo abdominal pressure required to overcome the resistance of the obstruction cervical –urethral, the other to an alteration of the aponeurotic wall structures with a progressive decrease of the resistance of tissues . The other most significant aspect is anatomically indicating a favorable joint treatment of diseases. Implemented the even more widespread surgical option are deferred treatment (12 months) of the two diseases, but in relation to ‘analysis of our experience you can make a joint surgical treatment. The purpose of this paper is to define the directions to an open question which is that of timing in the presence of contemporaneity of the two diseases.
Materials and Methods
Patients seen in Codest study and referred to the Joint treatment and two groups were divided;
A) The 1983-93 group I Patients seen at the Surgical Clinic II Hospital Garibaldi Catania are No 68, No 46 of these were treated with adenomectomy trans bladder and hernia repair, the other No. 22 with TUR-P (Trans urethal resection prostatic) and hernioplasty
B) The group II 1994-2004 observed patients No 73 at the Surgical Clinic III Hospital Policlinico, and from 2004 to 2014 are n 71 at the Department of specialized surgical sciences II Policlinico Catania. Of these 103 cases undergo adenomectomy trans bladder and hernia repair, the remaining n 41 with a TUR-P (transurethral resection prostatic) and hernioplasty. l ‘age was between 65-90, with a mean age 74. The risk factors were: cardiovascular diseases, age. Metabolic diseases (diabetes, kidney failure,), obesity, BPCO (chronic obstructive pulmonary disease). Such patients taken under observation accounted for 23% of all cases of EI (inguinal hernia) treated, and 49% of cases of BPH (benign prostatic hypertrophy) observed and operated at the Department of specialized surgical sciences II. The treatment is in the first group was made a spinal anesthesia in 90% of cases and in the remaining 10% of patients was carried out under general anesthetic. In Group II the spinal anesthesia was performed in all patients, and in the few cases (8 cases. 5.5%) in which the anesthetic technique had a shorter duration we proceeded with the prosthetic hernioplasty with loco regional anesthesia. The surgical treatment for joint pathologies made in the two groups was that of a suprapubic incision extending sec Pfannenstiel incision on the projection of the inguinal ligament see (Figures 1,2)
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