Application of tension-free hernioplasty with hernia meshes of different materials and the postoperative effects on the reproductive function of male rats

Abstract

This study aimed to compare the effects of polypropylene (PP), lightweight PP (UP) and expanded polytetrafluorethylene (e-PTFE) hernia mesh on the reproductive function of adult male Sprague-Dawley (SD) rats following open tension-free hernioplasty. Forty adult SD rats were obtained and divided into five groups: A sham-operated (FO) group, an e-PTFE mesh group, a PP mesh group, the UP mesh group and a normal control (NC) group (without any surgical manipulation). Ninety days following open tension-free hernioplasty, hematoxylin and eosin staining and immunhistochemistry were used to observe the pathological changes of the testicular tissue and to compare the expression of hypoxia-inducible factor-1α (HIF‑1α) in the rat testis, respectively. ELISA was used to analyze the serum concentration of antisperm antibodies (AsAbs) and routine semen testing was conducted to measure the percentage of grade a+b sperm from the epididymis. More than 50% of mesh adherence to the spermatic cord was observed in the PP and UP groups, and mild or no adhesion was observed in the NC, FO and e-PTFE groups. In the UP and PP groups, marked congestion of necrotic tissue was observed in the seminiferous tubule cavity, a significant reduction in the percentage of grade a+b sperm and a significant increase in the expression levels of AsAbs and HIF-α. It was concluded that the e-PTFE mesh exhibited a marginal effect on the reproductive function of rats compared with that of the PP and UP mesh and is more suitable for tension-free hernioplasty. The clinical significance of these results requires further elucidation with a multi-centered prospective study.

Does a Bilateral Polypropylene Mesh Alter the Duct Deferens Morphology, Testicular Size and Testosterone Levels? Experimental Study in Rats

“…19 In a later study involving a histological analysis of rat testicles 90 days after PP mesh implantation, the authors described an intense congestion in the necrotic tissue of the seminiferous tubules with significant reduction in spermatozoa type a and b and an increase in antisperm antibodies in serum. 20 These data show that, in a more sensitive analysis, there may be changes in spermatogenesis that do not necessarily negatively impact fertility.…”

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

“…After 180 days, vasography revealed relevant obstructions (>75% of the lumen diameter) located at the mesh margins in half of the cases but did not impact spermatogenesis; however, in this study, there was no control group without surgery or surgery without mesh implantation 19 . In a later study involving a histological analysis of rat testicles 90 days after PP mesh implantation, the authors described an intense congestion in the necrotic tissue of the seminiferous tubules with significant reduction in spermatozoa type a and b and an increase in antisperm antibodies in serum 20 . These data show that, in a more sensitive analysis, there may be changes in spermatogenesis that do not necessarily negatively impact fertility.…”

“…The majority of these studies do not show a negative association even with the PP mesh 11,21 , which promotes increased activation of macrophages and, consequently, a more intense inflammatory reaction than low molecular weight screens 23 . However, all these models fail to include a group without mesh implantation for comparison [18][19][20][21][22] .…”

Effectiveness of polypropylene mesh coated bovine amniotic membrane with adhesion barrier (polyethylene glycol) in repair of abdominal wall hernias in rats

“…Absorbable meshes used for hernia repair only provide a temporary solution. Therefore, a mesh used for hernia repair should be non-absorbable (Xu et al 2014). Hence non-absorbable PP mesh was used in this study.…”