Influence of a new self-gripping hernia mesh on male fertility in a rat model
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The number of mesh-based therapies of inguinal hernias is increasing compared with the classical suture techniques such as Shouldice and Bassini. Many different types of meshes with regard to material, pore size and surface coating are available. A recently offered mesh (Parietene™ Progrip™) combines the properties of a standard lightweight polypropylene mesh with a whole surface fixation by incorporation of micro hooks. Therefore, additional fixation elements such as screws, tacks or clips become redundant when using this material. However, in treated male patients the micro hooks will also come into contact with the ductus deferens. As the sensitivity of this structure is known, the question arises of whether this new self-gripping mesh might damage susceptible tissue layers and impair male fertility.
Two different meshes, a standard lightweight polypropylene mesh (Parietene-Light™) and a new self-gripping polypropylene mesh (Parietene™ Progrip™) with absorbable micro hooks were wrapped surgically around the prepared ductus deferens of each of ten Sprague–Dawley rats. In five control rats ducts were only separated bluntly from adherent tissue. After 2 months rats were sacrificed and implants were recovered together with the ductus deferens for histology and electron microscopy.
Samples from all animals showed an unrestricted lumen of the ductus deferens. Only minor inflammatory reactions with some infiltrating cells could be observed. Giant cells were present around the mesh fibres. Scanning electron microscopy revealed no degradation of the material surface after 2 months of implantation.
The new self-gripping mesh showed no harmful influence on the ductus deferens in the rat model. Considering the larger dimensions of the ductus deferens in humans any detrimental effect on the exposed tissue can be excluded. The surface of the fibres was not subjected to material degradation.
KeywordsMesh fixation Parietene Progrip Ductus deferens Rat model Laparoscopic inguinal herniorrhaphy
Many thanks to Dr. Claus Vogl, Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna for statistical analysis and Dr. Birgit Strobl, Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna for critical review of the manuscript .
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