Fertility of men following inguinal hernia repair

Abstract

Among 8500 patients attending the fertility clinic due to infertility, 565 men (6.65%) reported an incidence of inguinal hernioplasty with or without subsequent atrophy of the testis. Semen quality (sperm concentrations, motility, and morphology) of these patients was markedly reduced in comparison to that of fertile men. In cases where hernioplasty was followed by atrophy of the testis, damage to sperm characteristics and Sertoli cell function was found to be far greater. This was also reflected in significant serum follicle stimulating hormone elevation ( P < 0.0025). No changes in luteinizing hormone and testosterone were found. No correlation was found between age of hernioplasty and semen quality following operation. The reasons for testicular damage may be due to ischaemic orchitis or immunological reactions.

A comparison of preoperative and postoperative testicular volume and blood flow in patients with inguinal hernia, hydrocele, and cord cyst: A prospective cohort study

“…This is a much higher value than those reported previously, which were in the order of 0-2% 18. Incidentally, the authors of this previous study also observed high values of follicle stimulating hormone (FSH) and proposed that testicular damage may represent the result of ischemic orchitis or immunological reactions 18…”

“…These findings contradict with the high proportion of infertile males who had undergone inguinal hernia surgery earlier in their lives. Although other publications report the negative effects of inguinal hernia surgery upon male patients, these usually involve inguinal hernia surgeries carried out during adulthood 18. We recommend that the long-term effects of childhood inguinal hernia surgery upon fertility should be evaluated separately.…”

Influence of a new self-gripping hernia mesh on male fertility in a rat model

“…It is the only tubular organ of the body in which the diameter of the lumen is less than the thickness of the wall. As the ductus deferens is a quite sensitive structure, especially in juveniles [10], the effect of hernia meshes on it was addressed by several authors, both in humans [6,7,11,12] and in animal models (canine [13,14]; porcine and rabbit [15,16]; rat [5,[17][18][19][20]). …”

Nationwide survey to evaluate medical utilization by patients with inguinal hernia and the risk of developing varicocele in Taiwan

“…The incidence of inguinal hernia in infertile Israeli men has been reported to be 6.65% 21. Patients with a varicocele may complain of a dull throbbing scrotal pain or pulling or dragging sensation that is worsened with straining and exercise;22 however, this scrotal pain may be due to inguinal hernia.…”