24Dec 2019

BILATERAL LICHTENSTEIN TENSION FREE REPAIR OF INGUINAL HERNIA AND TESTICULAR FUNCTION: A PROSPECTIVE CLINICAL TRIAL

  • General surgery department.Zagazig university, Egypt
Crossref Cited-by Linking logo

  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background:Lichtenstein tension free repair of inguinal hernia a very effective repair but fibrosis generated around the mesh prosthesis may be hazardous to the vas deference and testicular blood supply thus impairing testicular function especially if done on both sides. Patient and methods:78 patients with bilateral inguinal hernia recruited in this prospective trial for evaluation of the effect of bilateral Lichtenstein tension free repair of inguinal hernia on testicular function we held comparison between preoperative and 6 months postoperative findings of; testicular volume, testicular blood flow (resistive index) semen analysis and free testosterone level as primary outcome and surgical site occurrences and recurrence rate as secondary outcome. Results: mean Age, BMI, Operative time were 33.1? 8.8 years , 27.6? 3.1, and 98.4?11.4 respectively, majority of hernia presentation was indirect hernia, we got 2 cases of chronic pain, one case of hydrocele and no recurrences, regarding testicular volume, resistive index, semen analysis and testosterone level noticed non-significant differences between pre and post repair results. Conclusion:In regard to testicular function, bilateral Lichtenstein tension free repair of inguinal hernia is an effective safe method, especially if laparoscopic repair is not available.

  1. Gould, J. (2008). Laparoscopic versus open inguinal hernia repair. Surgical Clinics of North America, 88(5), 1073-1081.
  2. Amid PK, Friis E, Horeyseck G, Kux M (1999) A multi-center experience with 6764 Lichtenstein tension-free hernioplasties. Hernia 3:47?8
  3. Lichtenstein IL, Shulman AG, Amid PK, MontXor MM (1989) the tension-free hernioplasty. Am J Surg 157:188?193
  4. Hubner M, Vuilleumier H, Demartines N (2008) Sexual impairment due to mesh plug hernia repair? ANZ J Surg 78:213?219
  5. Miller, H. J. (2018). Inguinal Hernia: Mastering the Anatomy. Surgical Clinics of North America, 98(3), 607-621.
  6. Dilek, O. N. (2014). Hernioplasty and testicular perfusion. Springerplus, 3(1), 107.
  7. Khan LR, Kumar S, Nixon SJ. (2006). Early results for new lightweight mesh in laparoscopic totally extra-peritoneal inguinal hernia repair. Hernia. 2006 Aug; 10(4):303-8.
  8. Shin D, Lipshultz LI, Goldstein M, Barme GA, Fuchs EF, Nagler HM, McCallum SW, Niederberger CS, Schoor RA, Brugh VM, Honig SC (2005) Herniorrhaphy and polypropylene mesh causing inguinal vassal obstruction: a preventable cause of obstructive azoospermia. Ann Surg 241(4):553?558
  9. Fitzgibbons RJ (2007). The mesh and the spermatic cord. In: Schumpelick V, Fitzgibbons RJ (eds) Recurrent Hernia. Springer, Heidelberg, pp 333?337.
  10. Turgut, A. T., ?l??c?oğlu, E., Turan, C., Kili?oğlu, B., Koşar, P., Geyik, P. ?., & Dogra, V. (2007). Preoperative ultrasonographic evaluation of testicular volume and blood flow in patients with inguinal hernias. Journal of Ultrasound in Medicine,26(12), 1657-1666.
  11. Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1:15?21
  12. Beddy P, Ridgway PF, Geoghegan T, Peirce C, Govender P, Kean FB, Torreggiani WC, Conlon KE (2006) Inguinal hernia repair protects testicular function: a prospective study of open and laparoscopic herniorraphy. Am Coll Surg 203(1):17-23
  13. Taylor SG, Hair A, Baxter GM, O?Dwyer PJ (2001) Does contraction of mesh following tension free hernioplasty eVect testicular or femoral vessel blood Xow? Hernia 5:13?15
  14. Pepe P, Aragona F (2007) Testicular ischemia following mesh hernia repair and acute prostatitis. Ind J Urol 23(3):323?325
  15. Lima Neto EV, Goldenberg A, Juca MJ (2007) Prospective study on the eVects of a polypropylene prosthesis on testicular volume and arterial Xow in patients undergoing surgical correction for inguinal hernia. Acta Cir Bras 22(4):226?271.
  16. Zieren J, BeyersdorV D, Beier KM, Muller JM (2001) Sexual function and testicular perfusion after inguinal hernia repair with mesh. Am J Surg 181:204?206
  17. Ramadan SU, Gokharman P, Tuncbilek I, Ozer H, Kosar P, Kosar U (2007) Does mesh/perimesh Wbrosis have an eVect on testicular Xow in patients with repaired inguinal hernia? Utraschall Med 28 (abstract)
  18. Homonnai ZT, Fainman N, Paz GF, David MP (1980) Testicular function after herniotomy. Herniotomy and fertility. Andrologia 12:115?120
  19. Aydede, H., Erhan, Y., Sakarya, A., Kara, E., Ilkgul, ?, & Can, M. (2003). Effect of mesh and its localization on testicular flow and spermatogenesis in patients with groin hernia. Acta Chirurgica Belgica, 103(6), 607-610.

[Ahmed M. El Teliti, Mostafa M. Khairy and Hazem Nour (2019); BILATERAL LICHTENSTEIN TENSION FREE REPAIR OF INGUINAL HERNIA AND TESTICULAR FUNCTION: A PROSPECTIVE CLINICAL TRIAL Int. J. of Adv. Res. 7 (Dec). 87-90] (ISSN 2320-5407). www.journalijar.com

Ahmed M. El Teliti
General surgery department.Zagazig university, Egypt

DOI:

Article DOI: 10.21474/IJAR01/10129      
DOI URL: https://dx.doi.org/10.21474/IJAR01/10129

Download Full Paper

Download PDF No. of Downloads: 18 | No. of Views: 182