Can Laparoscopic Hernia Repair Alter Function and Volume of Testis?

Abstract

Testicular atrophy is a sequela of inguinal hernioplasty. The purpose of this study was to evaluate the effects of Lichtenstein (LHR) and laparoscopic totally extraperitoneal (TEP) hernia repair techniques on testicular function and volume. This study is a randomized prospective clinical trial with the blind assessment of outcome. A total of 26 patients who underwent elective herniorrhaphy for groin hernia were included in the study. Each patient was randomly assigned into one of two groups: either TEP or LHR (n = 13 for each). Six of the patients had bilateral hernia (n = 3 for each group). Luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone levels, and testicular volume by Doppler ultrasonography were detected just before and 3 months after the operation. LH, FSH levels did not change, when compared preoperative and postoperatively in both groups. Testicular volume and testosterone levels were observed to be significantly decreased after TEP when compared with LHR while no significant preoperative changes were observed between those groups. This affected the testicular volume in normal limits. TEP or LHR could not affect LH, FSH, testosterone values, but TEP could lead a decreasing effect on volume of testis in normal limits.

Prospective study on the effects of a polypropylene prosthesis on testicular volume and arterial flow in patients undergoing surgical correction for inguinal hernia

“…Wantz 6 described testicular atrophy as a consequence of ischemic orchitis that could occur in patients who underwent operations with or without prostheses. In the present study, no statistically significant difference was seen between the three observation times in relation to testicular volume (p= 0.197) ( Tables 1 to 4 17 . The TEP technique puts the elements of the spermatic funiculus in contact with the prosthesis.…”

“…As demonstrated in the studies by Aydede et al 16 and Akbulut et al 17 , the prosthesis produces different repercussions according to where it has been implanted. Placement of the prosthesis in the pre-peritoneal position, as part of a variety of techniques, has been found to cause more repercussions on the testicle and the testicular flow than does the Lichtenstein technique 16,17 . The latter procedure was the only one that presented homogeneous results in dozens of multicenter studies with recurrence rates of 1%.…”

“…Alterations to testicular blood flow were observed on the third postoperative day in both groups. Akbulut et al 17 also evaluated the effects of prostheses on testicular function and volume using the Lichtenstein and laparoscopic TEP techniques. Twenty-six patients allocated into two groups of 13 were studied.…”

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

“…Testicular atrophy following hernioplasty is a rare complication with an incidence of 0.5% for primary hernia repair, but it causes much anxiety and often leads to litigation [12] . Our previous report included the same population, and neither TEP nor LHR affected testicular function, but TEP decreased testicular volume but in normal limits [13] .…”

Is testicular perfusion influenced during laparoscopic inguınal hernia surgery?

“…Until recently, only two data existed regarding testicular function after laparoscopic inguinal hernia surgery [1,17]. However, a literature search showed no study on testicular flow changes after laparoscopic inguinal hernia repair in the early postoperative period.…”