Androgen Deprivation Therapy & Inguinal Hernia

[pjoshea13]

New study from Sweden below [1].

"It has been suggested that hypogonadism increases the risk for inguinal hernia (IH)."

"The study population in this population-based nested case-control study was based on data from the Prostate Cancer Database Sweden. The cohort included all men with prostate cancer who had not received curative treatment. Men who had been diagnosed or had undergone IH repair (n = 1,324) were cases and controls, where not diagnosed, nor operated on for IH, matched only on birth year ..."

The risk of inguinal hernia was low in the first 8 years of ADT.

But after 9 years, the risk factor jumped to 3.68.

"The low risk for IH during the first 8 years on ADT is likely caused by selection of men with advanced cancer unlikely to be diagnosed or treated for IH."

"The marked increase in OR for IH after 9 years of ADT supports the hypothesis that low testosterone levels increase the risk for IH."

{Wiki: en.wikipedia.org/wiki/Ingui...

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/349...

Am J Mens Health

. Nov-Dec 2021;15(6):15579883211058606. doi: 10.1177/15579883211058606.

Androgen Deprivation Therapy and the Risk for Inguinal Hernia: An Observational Nested Case Control Study

Maria Hermann 1 2 , Hanna Vikman 3 , Pär Stattin 3 , Asmatullah Katawazai 4 , Ove Gustafsson 1 2 , Johan Styrke 5 , Gabriel Sandblom 6 7

Affiliations collapse

Affiliations

1 Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.

2 Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.

3 Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.

4 Department of Surgery, Örebro University Hospital, Örebro, Sweden.

5 Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University Hospital, Umeå, Sweden.

6 Department of Clinical Science and Education Södersjukhuset, Karolinska Institute, Stockholm, Sweden.

7 Department of Surgery, Södersjukhuset, Stockholm, Sweden.

PMID: 34918553 DOI: 10.1177/15579883211058606

Abstract

It has been suggested that hypogonadism increases the risk for inguinal hernia (IH). The aim of this study was to investigate any association between androgen deprivation therapy (ADT) for prostate cancer and increased risk for IH. The study population in this population-based nested case-control study was based on data from the Prostate Cancer Database Sweden. The cohort included all men with prostate cancer who had not received curative treatment. Men who had been diagnosed or had undergone IH repair (n = 1,324) were cases and controls, where not diagnosed, nor operated on for IH, matched only on birth year (n = 13,240). Conditional multivariate logistic regression models were used to assess any temporal association between ADT and IH, adjusting for marital status, education level, prostate cancer risk category, Charlson Comorbidity Index, ADT, time since prostate cancer diagnosis, and primary prostate cancer treatment. Odds ratio (OR) for diagnosis/repair of IH 0 to 1 year from start of ADT was 0.5 (95% confidence interval [CI] = [0.38, 0.68]); between 1 and 3 years after, the OR was 0.35 (95% CI = [0.26, 0.47]); between 3 and 5 years after, the OR was 0.39 (95% CI = [0.26, 0.56]); between 5 and 7 years after, the OR was 0.6 (95% CI = [0.41, 0.97]); and >9 years after, the OR was 3.68 (95% CI = [2.45, 5.53]). The marked increase in OR for IH after 9 years of ADT supports the hypothesis that low testosterone levels increase the risk for IH. The low risk for IH during the first 8 years on ADT is likely caused by selection of men with advanced cancer unlikely to be diagnosed or treated for IH.

Keywords: androgen deprivation therapy; hernia; inguinal hernia; prostate cancer; sex hormones.

[maley2711]

What to do with such info? Decline ADT? I believe I already have asymptomatic IH seen in MRI apparently. Mine would be expected to worsen with ADT?

[Hidden]

I would add that chronic constipation would add to that hernia risk even more.

[CAMPSOUPS]

Well only 2 years in for me and although anecdotal I am 100% aware of abdominal wall weakening. Times I have coughed hard or performed a strenuous task I have said to myself better be very careful because I can feel that push happening below the abdominal muscles, that its about to pop thru.

[j-o-h-n]

P. Hernias played tight end for the Michigan Mesh..... always near the balls but never ever carried any.....Truss me I know....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/19/2021 3:05 PM EST