One or two years after radical prostatectomy, about 15 percent of men turn out to have inguinal hernias. Patrick C. Walsh, M.D., has been interested in this phenomenon since he first noticed it several years ago. He believes that many of these hernias may have been present before surgery—but they just weren’t diagnosed.

With this idea in mind, he and Matthew E. Nielson, M.D., a resident at the Brady Urological Institute, studied 430 patients who underwent surgery between September 2001 and December 2004. The extra scrutiny paid off: "We found that if one looks very carefully at the time of surgery, about onethird of patients have hernias," he says, "and in 40 percent of these patients, the hernias were on both sides." These hernias were repaired during the radical prostatectomy procedure. Although none of the hernias that were repaired came back, a few of these men — 5 percent — developed another hernia after surgery, at a new site.

This study suggests that at the time of radical prostatectomy, urologists should carefully examine the patient for the presence of a hidden hernia, "and if one is found, it should be repaired," Walsh says. "We hope this will significantly reduce the development of a hernia following surgery."