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Self-fixing parietex progrip versus the standard sutured prolene mesh in tension-free repair of inguinal hernia: effect on testicular volume and testicular blood flow

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Abstract

Our study was conducted to compare self-fixing lightweight polyester mesh (group I) to the standard heavy weight polypropylene mesh (group II) using tension-free Lichtenstein hernioplasty as regard to the effect of mesh implantation and perimesh fibrosis on testicular blood flow. 80 patients with uncomplicated inguinal hernia were divided in two groups. Doppler ultrasonography measured testicular volume, testicular artery velocity preoperative and 3rd month post operative. Blood flow in the testicles was represented by resistive index (RI). No case of testicular atrophy occurred in either group, however, in both groups a significant postoperative decrease in testicular volume (p = 0.001 in group I and p < 0.001 in group II) was accompanied by a significant increase in RI as compared to their pre-operative values (p < 0.001 in group I and p = 0.009 in group II). Comparing the two groups, patients in group I showed higher values of decrease in testicular volume accompanied by more increase in RI values postoperatively compared to group II patients, but these values did not reach a significant value (p = 0.107, p = 0.136). There was a significant increase in the number of post-operative varicocele and hydrocele in group I compared to group II. Mesh implantation has an effect on testicular size and blood flow by decreasing the testicular size and increasing the RI. This effect was more obvious in the parietex progrip. Although there is an indirect relation between RI and the sperm count, testicular blood flow alone is not enough to judge fertility.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, University of Alexandria, El Sultan Hussein Street, El-Azarita, Khartoum Square, Alexandria, 21131, Egypt

    Heba El-Komy, Ahmed El-Gendi, Wael Abdel-salam, Mohamed Elseidy & Elsaid Elkayal

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  1. Heba El-Komy
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  2. Ahmed El-Gendi
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  3. Wael Abdel-salam
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  4. Mohamed Elseidy
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  5. Elsaid Elkayal
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Correspondence to Heba El-Komy.

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Heba El Komy, Ahmed El-Gendi, Wael Abdel-salam, Mohamed Elseidy, Elsaid Elkayal declare that they have no conflict of interest.

Research involving human participants and/or animals

The ethics committee and review board in our institute approved the study and treatment protocol.

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Informed consent was obtained from all patients who agreed to participate in the study.

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El-Komy, H., El-Gendi, A., Abdel-salam, W. et al. Self-fixing parietex progrip versus the standard sutured prolene mesh in tension-free repair of inguinal hernia: effect on testicular volume and testicular blood flow. Updates Surg 70, 513–520 (2018). https://doi.org/10.1007/s13304-018-0554-0

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  • DOI: https://doi.org/10.1007/s13304-018-0554-0

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