Are There Adverse Effects of Herniorrhaphy Techniques on Testicular Perfusion? Evaluation by Color Doppler Ultrasonography

Abstract

Purpose: To evaluate the efficacy of prosthetic meshes on testicular perfusion using color Doppler ultrasound (CDUS). Materials and Methods: This study is a randomized prospective clinical trial with blind assessment of outcome. A total of 26 patients who underwent elective herniorrhaphy for groin hernia participated in the study. Each patient was randomly assigned to 1 of 2 groups: totally extraperitoneal preperitoneal hernia repair (TEP; n = 13, mean age 46.7 ± 1.6 years) or Lichtenstein hernia repair (LHR; n = 13, mean age 54.2 ± 2.7 years). Six of the patients had bilateral hernias (n = 3 for each group). Blood flow indexes of the spermatic artery including end diastolic velocity (EDV), peak systolic velocity (PSV) and the resistive index (RI) were examined by CDUS. Ultrasound was performed just before the operations and repeated after 3 months. Kruskal-Wallis and Mann-Whitney U tests were used to evaluate the differences. Results:No statistically significant differences were found between the preoperative and postoperative measurements which included blood flow parameters (PSV, EDV, and RI) of the testes (p > 0.05). Conclusion:Neither the TEP or LHR technique had any decreasing effect on blood flow.

Laparoscopic inguinal hernia repair does not impair testicular perfusion

“…Not surprisingly, the results of Doppler measurements in adults were inconsistent. In some patient cohorts, laparoscopic mesh implantation was found to have no effect on testicular perfusion [10,11], whereas in other groups, there was an effect [9]. It may well be that measurements with O2C would have yielded more differentiated results.…”

“…In adult patients undergoing hernia repair, testicular perfusion was repeatedly measured, out of concern about unwanted side effects of mesh implantation [8][9][10][11]. Technically, in most instances, Doppler ultrasonography was used.…”

Do the manipulations in pediatric inguinal hernia operations affect the vascularization of testes?

“…Some researchers reported that all the parameters were affected in early postoperative period while they turned to their initial values in late postoperative period, and there was no pathologic finding in spermatogenetic function [8]. On the other hand, in some series it is stated that Doppler parameters are not affected in early postoperative period [9].…”

Testicular functions, chronic groin pain, and quality of life after laparoscopic and open mesh repair of inguinal hernia: a prospective randomized controlled trial

“…All previous studies [6,[24][25][26][27][28][29][30][31] have been mostly pilot studies (number of patients in each group = 13-30) with an incomplete study design. In a few studies only testicular volume [28] was assessed, while in others only hormone markers, semen analysis [31], or clinical examinations [27] were done. Moreover, the timing of assessment of testicular blood flow was inappropriate [25].…”