Does a bilateral polypropylene mesh alter the duct deferens morphology, testicular size and testosterone levels? Experimental study in rats

Purpose of the study. To evaluate morphological changes in the testes in experimental animals after tension-free inguinal hernia repair modeling.Materials and methods. The study included male rabbits, aged 120 days, weighing 3.8 ± 0.9 kg. All rabbits were divided into two groups depending on the type of operation: in the first group (n = 10) of animals, we made a model of tension-free inguinal hernia repair and used a polypropylene mesh; in the second group (n = 10) of animals, we left the structures of the inguinal canal intact. Morphological assessment of spermatogenesis was performed after 40 days. All morphometric measurements were carried out on strictly cross-sections of the convoluted seminal tubules.Results. In rabbits of group 1, the volume of the testicle was significantly three times less than in animals of group 2 (p < 0.05). In the animals of the first group, a significant deterioration in spermatogenesis was observed (p < 0.05). Histological examination of sections of the testes of these animals showed that hypoplasia of the spermatogenic epithelium was present in the convoluted seminal tubules, in 1/8 of the tubules there was subtotal aplasia of the spermatogenic epithelium, Sertoli-Cell-Only Syndrome was detected only in 2 %. Atrophy of the convoluted seminal tubules was not recorded at this period of observation. In the animals of the control group, almost 90 % of cases of spermatogenesis disorders were not detected.Conclusions. This experimental study on rabbits showed that after using a polypropylene mesh for inguinal canal plastic, inhibition of germ cell maturation occurs after 1.5 months. Therefore, in men of reproductive age, it is necessary to use polypropylene mesh implants with caution in terms of performing inguinal hernia repair.

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Male Fertility Following Inguinal Hernia Repair

Balawender¹,

Pliszka²

2023

Hernia Updates and Approaches

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Tension-free mesh hernia repair has become the standard procedure in inguinal hernia repair. The incidence of inguinal hernias has steadily decreased following mesh and laparoscopic techniques, but the potential risk of fertility disorders after surgery remains a controversial issue. The aim of this chapter was to establish the clinical impact of open (mesh and/or without mesh) and laparoscopic hernia repair on male fertility. The results of the research published to date do not allow clear conclusions and guidelines in hernia surgery for young patients of reproductive age. Evidence is inevitably difficult to find because of the wide range of causes of infertility and their complexity. However, the choice of method and the possible impact on fertility should be discussed with the patient before surgery. Additionally, preoperative and postoperative semen analysis will help exclude or confirm its impact on patient fertility in the future.

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Does a bilateral polypropylene mesh alter the duct deferens morphology, testicular size and testosterone levels? Experimental study in rats

Abstract: Conception and design of the study, technical procedures, analysis of data, manuscript writing.

Cited by 3 publications

References 24 publications

Bilateral inguinal hernia repair and male fertility: a randomized clinical trial comparing Lichtenstein versus laparoscopic transabdominal preperitoneal (TAPP) technique

Bilateral inguinal hernia repair and male fertility: a randomized clinical trial comparing Lichtenstein versus laparoscopic transabdominal preperitoneal (TAPP) technique

Morphological testicular changes following the experimental inguinal hernia repair modeling

Male Fertility Following Inguinal Hernia Repair

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