Repair of a hernia can be performed safely and expeditiously during a radical pelvic operation by the preperitoneal approach through a median longitudinal incision. We present the results of 41 preperitoneal herniorrhaphies performed simultaneously with 343 radical retropubic prostatectomies and 26 radical cystoprostatectomies. There was no evidence of hernial recurrence after a mean of 28 months and no complications attributable to the hernial repairs. We illustrate the preperitoneal anatomy, and the technique, which allows the safe and efficacious performance of a hernial repair during a urologic procedure.
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