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Phthalates and infertility: an issue in hernia meshes?

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Summary

Background

Based on recent data that sperm motility in humans might be (temporarily) affected when lightweight meshes are used for laparoscopic inguinal hernia repair, the aim of this study was to identify the plasticizers present in meshes used for hernia repair.

Methods

Mesh samples (n = 13) were cut into small pieces (1 cm × 1 cm), and, after the addition of internal standard, plasticizers were extracted with hexane:acetone (1:1; v:v) by vortex and ultrasonication. The analysis was performed by gas chromatography and mass spectrometry (GC-MS) in electron ionization mode (EI) with full scan acquisition. The identification of compounds was done by injection of reference standards and using the Wiley mass spectral library.

Results

None of the targeted plasticizers, including phthalates, were present in the analyzed mesh samples. In particular, di-(2-ethylhexyl) phthalate (DEHP), a major phthalate plasticizer frequently used in medical devices in the past, was not detected in any of the samples.

Conclusion

The implantation of mesh materials affecting male fertility, whether temporarily or not, cannot be explained by the presence of the targeted plasticizers, since none of them were found in the wide range of commonly used meshes that were tested in our study.

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Acknowledgements

The table was compiled with the product information received by each company.

Authors’ Contributions

Study conception and design: Van De Winkel, Yurtkap, Van Schepdael, Miserez

Acquisition of data: Van De Winkel, Yurtkap

Analysis and interpretation of data: Malarvannan, Covaci, Van De Winkel

Drafting of manuscript: Van De Winkel, Dhooghe

Critical revision and approval final manuscript: all authors

Author information

Authors and Affiliations

  1. Department of Abdominal Surgery, UZ Leuven—University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium

    Nele Van De Winkel, Vicky Dhooghe & Marc Miserez

  2. Department of Surgery, Erasmus Medisch Centrum, Doctor Molewaterplein 40, 3015 Rotterdam, The Netherlands

    Yagmur Yurtkap

  3. Department of Pharmaceutical and Pharmacological Sciences, Pharmaceutical Analysis, KU Leuven—University of Leuven, Herestraat 49, O&N2, PB 923, 3000, Leuven, Belgium

    Shengyun Huang & Ann Van Schepdael

  4. Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium

    Govindan Malarvannan & Adrian Covaci

  5. Department of Pharmaceutical and Pharmacological Sciences, Drug Delivery and Disposition, KU Leuven—University of Leuven, Herestraat 49, b921, 3000, Leuven, Belgium

    Guy Van den Mooter

Authors
  1. Nele Van De Winkel
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Corresponding author

Correspondence to Nele Van De Winkel.

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Conflict of interest

N. Van De Winkel reports personal fees from Lifebond. M. Miserez reports personal fees from Springer, grants and personal fees from BARD, grants from Duomed, personal fees from Lifebond, personal fees from Medtronic, outside the submitted work. Y. Yurtkap, V. Dhooghe, S. Huang, G. Malarvannan, G. Van den Mooter, A. Covaci, and A. Van Schepdael declare that they have no competing interests.

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Van De Winkel, N., Yurtkap, Y., Dhooghe, V. et al. Phthalates and infertility: an issue in hernia meshes?. Eur Surg 52, 210–216 (2020). https://doi.org/10.1007/s10353-020-00636-1

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  • DOI: https://doi.org/10.1007/s10353-020-00636-1

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