Skip to main content

Advertisement

SpringerLink
Log in

Influence of inguinal hernia mesh repair on testicular flow and sperm autoimmunity

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Background

The incidence of infertility caused by the mesh inguinal hernia repair is not known. The aim of this study was to determine circulation and immunological testicular disorders after inguinal hernia mesh repair which can be related with infertility.

Methods

From February 2010 to December 2010, 43 male patients who underwent inguinal hernia mesh repair were included in a prospective study. Testicular, capsular and intratesticular arterial flow dynamics were measured by Color Doppler ultrasound before the operation, in early and late postoperative period. The antisperm antibodies were analyzed before hernia repair and 5 months after.

Results

The difference between patients who underwent laparoscopic (Group I) and anterior open tension-free hernia repair (Group II) in age, duration of symptoms and hernia characteristics were not significant. Statistically significant differences were found in peak-systolic and end-diastolic velocity in testicular and intratesticular arteries in Group II and in peak-systolic velocity on all levels in Group I. Only Group I had significant differences in resistive index of intratesticular arteries. All the values returned to basal in late postoperative period except testicular peak-systolic velocity in Group I which stayed in normal range. Wilcox matched pair test showed significant difference between preoperative and late postoperative measurements of the antisperm antibodies only in Group II, but it was within normal range in all cases.

Conclusions

Inguinal hernia mesh repair do not have clinically significant influence on testicular flow and immunological response.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sršen D, Družijanić N, Pogorelić Z, Perko Z, Juričić J, Kraljević D, Krnić D, Bilan K, Mimica Ž (2008) Quality of life analysis after open and laparoscopic inguinal hernia repair—retrospective study. Hepatogastroenterology 55:2112–2115

    PubMed  Google Scholar 

  2. Perko Z, Rakić M, Pogorelić Z, Družijanić N, Kraljević J (2011) Laparoscopic transabdominal preperitoneal approach for inguinal hernia repair: a five-year experience at a single center. Surg Today 41:216–221

    Article  PubMed  Google Scholar 

  3. Mosher WD, Pratt WF (1991) Fecundity and infertility in the United State incidence and trends. Fertil Steril 56:192–193

    PubMed  CAS  Google Scholar 

  4. Yavetz H, Harash B, Yogev L, Homonnai ZT, Paz G (1991) Fertility of men following inguinal hernia repair. Andrologia 23:443–446

    Article  PubMed  CAS  Google Scholar 

  5. Maciel LC, Glina S, Palma P, Nascimento LF, Netto NR (2007) Histopathological alterations of the vas deferens in rats exposed to polypropylene mesh. BJU Int 100:87–190

    Article  Google Scholar 

  6. Peiper C, June K, Klinge U, Strehlau E, Ottingr A, Schumpelick V (2006) Is there a risk of infertility after inguinal mesh repair? Experimental studies in the pig and the rabbit. Hernia 10:7–12

    Article  PubMed  Google Scholar 

  7. Aydede H, Erhan Y, Sakärya A, Kara E, Ilkgül O, Can M (2003) Effect of mesh and its localisation on testicular flow and spermatogenesis in patients with groin hernia. Acta Chir Belg 103:607–610

    PubMed  CAS  Google Scholar 

  8. Scullu I, Filiz AI, Sen B, Ozdemir Y, Yucel E, Sinan H, Dandin O, Kurt Y, Gulec B, Ozyurt M (2010) The effects of inguinal hernia repair on testicular function in young adults: a prospective randomized study. Hernia 14:165–169

    Article  Google Scholar 

  9. Hallen M, Sandblom G, Nordin P, Gunnarsson U, Kvist U, Westrdahl J (2011) Male infertility after mesh hernia repair: a prospective study. Surgery 149:79–84

    Article  Google Scholar 

  10. The ESHRE Capri Worshop Group (1998) Male infertility update. Hum Reprod 13:2025–2032

    Article  Google Scholar 

  11. Chehval MJ, Doshi R, Kidd CF, Winkelmann T, Chehval V (2002) Antisperm autoantibody response after unilateral vas deferens ligation in rats: when does it develop? J Androl 23:669–673

    PubMed  Google Scholar 

  12. Jaeningen BM, Hopt UT, Obermaier R (2008) Inguinal hernia:mesh or no mesh in open repair? Zentralbl Chir 133:440–445

    Article  Google Scholar 

  13. Sheynkin YR, Herdin BN, Schlegel PN (1998) Microurgical repair of iatrogenic injury to the vas deferens. J Urol 159:139–141

    Article  PubMed  CAS  Google Scholar 

  14. Shin D, Lipshultz LI, Goldstein M, Barme GA, Fuchs EF, Nagler HM, McCallum SW, Niederberger CS, Schoor RA, Brugh VM III, Honing SC (2005) Herniorrhaphy with polypropylene mesh causing inguinal vasal obstruction. Ann Surg 241:553–558

    Article  PubMed  Google Scholar 

  15. Chiu WC, Chamley LW (2004) Clinical associations and mechanisms of action of antisperm antibodies. Fertil Steril 83:529–535

    Article  Google Scholar 

  16. Lee R, Goldstein M, Ullery BW, Ehrilch J, Soares M, Razzano RA, Herman MP, Callahan MA, Li PS, Schlegel PN, Witkin SS (2009) Value of serum antisperm antibodies in diagnosing obstructive azoospermia. J Urol 181:264–269

    Article  PubMed  CAS  Google Scholar 

  17. Matsuda T, Ogura K, Muguruma K, Yoshida O, Horri Y (1993) Serum antisperm antibodies in men with vas deferens obstruction caused by chilhood inguinal herniorrhaphy. Fertil Steril 59:1095–1097

    PubMed  CAS  Google Scholar 

  18. Lewis-Jones DI, Moreno de Marval M, Harrison RG (1982) Impairment of rat spermatogenesis following unilateral experimental ischemia. Ferti Steril 38:482–490

    CAS  Google Scholar 

  19. Friberg J, Fritjoffson A (1979) Inguinal herniorhaphy and spermaagglutinting antibodies in infertil men. Arch Androl 2:317–322

    Article  PubMed  CAS  Google Scholar 

  20. Kapral W, Kollaritsch H, Stemberger H (1990) Correlation of inguinal hernia and agglutinating sperm antibodies. Entralbl Chir 115:369–377

    CAS  Google Scholar 

  21. Gilbert BR, Witkin SS, Goldstein M (1989) Correlation of sperm-bound immunoglobulins with impaired semen analysis in infertile men with varicoceles. Fertil Steril 52:469–473

    PubMed  CAS  Google Scholar 

  22. Ersin S, Aydin U, Makay O, Icoz G, Tamsel S, Sozbilen M, Killi R (2006) Is testicular perfusion influenced during laparoscopic inguinal hernia surgery? Surg Endosc 20:685–689

    Article  PubMed  CAS  Google Scholar 

  23. Beddy P, Ridgway PF, Geoghegan T, Peirce C, Govender P, Keane FB, Torreggiani WC, Conlon KC (2006) Inguinal hernia repair protects testicular function: a prospective study of open and laparoscopic herniorraphy. J Am Coll Surg 203:17–23

    Article  PubMed  Google Scholar 

  24. Leibl BJ, Kraft B, Redecke JD, Schmedt CG, Ulrich M, Kraft K, Bittner R(2002) Are postoperative complaints and complications influenced by different techniques in fashioning and fixing the mesh in transperitoneal laparoscopic hernioplasty? Results of prospective randomized trail. World J Surg 26:1481–1484

    Google Scholar 

  25. Pinggera GM, Mitterberger M, Bartsch G, Strasser H, Gradl J, Aigner F, Pallovein L, Frauscher F (2008) Assessment of the intratesticular resistive index by color Doppler ultrasonography measurements as a predictor of spermatogenesis. BJU Int 101:722–726

    Article  PubMed  Google Scholar 

  26. Middleton WD, Thorne DA, Melson GL (1989) Color doppler ultrasound of the normal testis. Am J Roentgenol 152:293–297

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Split, Split University School of Medicine, Split, Croatia

    I. Štula

  2. Department of Surgery, University Hospital Split, Split University School of Medicine, Split, Croatia

    N. Družijanić, Z. Perko & D. Kraljević

  3. Department of Orthopedics, University Hospital Split, Split University School of Medicine, Split, Croatia

    D. Sršen

  4. Department of Nuclear Medicine, University Hospital Split, Split University School of Medicine, Split, Croatia

    V. Čapkun

  5. Department of Clinical Laboratory Diagnostics, University Hospital Split, Split University School of Medicine, Split, Croatia

    A. Sapunar & N. Bošnjak

  6. Department of Pediatric Surgery, University Hospital Split, Split University School of Medicine, Spinčićeva 1, 21000, Split, Croatia

    Z. Pogorelić

Authors
  1. I. Štula
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Družijanić
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Sršen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Čapkun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Z. Perko
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Sapunar
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D. Kraljević
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. N. Bošnjak
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Z. Pogorelić
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Z. Pogorelić.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Štula, I., Družijanić, N., Sršen, D. et al. Influence of inguinal hernia mesh repair on testicular flow and sperm autoimmunity. Hernia 16, 417–424 (2012). https://doi.org/10.1007/s10029-012-0918-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-012-0918-1

Keywords

Search

Navigation