Marlex mesh causing inguinal vasal obstruction: a treatable, preventable cause of obstructive azospermia.

Barme, G; Honig, Susanne; Fuchs, E; Ohl, Dana A.; Meacham, Randall B.; McCallum, Stewart W.

doi:10.1016/s0015-0282(01)02649-8

Cited by 3 publications

(4 citation statements)

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“…Microsurgical inguinal vasovasostomies have been reported to have a patency rate of up to 88.9% 2. However, in cases of vasal obstruction secondary to inguinal hernia repair with mesh, the success rate of traditional primary vasovasostomy is reduced, if even feasible, due to the long vasal segment embedded in dense fibrosis 4…”

Section: Discussionmentioning

confidence: 99%

“…Injury to the vas deferens is an uncommon but known complication of inguinal hernia repair 1–3. Similarly, obstruction of the vas deferens from mesh used for inguinal hernia repair can occur leading to infertility 1 4. Surgical reconstruction of the vas deferens after inguinal hernia repair can be challenging if not impossible, often limited by the obliteration of a long vasal segment due to fibrosis.…”

Section: Introductionmentioning

confidence: 99%

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Combined robotic and subinguinal microsurgical vasovasostomy for vasal obstruction after inguinal hernia repair

Wald

Steinberg

2022

BMJ Case Rep

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Obstruction of the vas deferens may occur after inguinal hernia repair with mesh and lead to infertility. In cases where natural conception is desired and after obtaining test results that suggest the presence of spermatogenesis, surgical reconstruction can be attempted but may be difficult. Several approaches have been reported, including the laparoscopic mobilisation of the pelvic vas deferens, as well as mobilisation and passage of the scrotal vas deferens intra-abdominally for robot-assisted vasovasostomy. We describe a novel approach that used the surgical robot and a no-touch technique to mobilise the pelvic vas deferens and deliver it to the subinguinal region for subinguinal microsurgical vasovasostomy. This approach appeared to be feasible and safe, allows for simultaneous bilateral repair if needed, and was associated with rapid postoperative convalescence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combined robotic and subinguinal microsurgical vasovasostomy for vasal obstruction after inguinal hernia repair

Wald

Steinberg

2022

BMJ Case Rep

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show abstract

“…Patency rates of inguinal vasovasostomies have been reported up to 88.9% with microsurgical repair (1). However, when mesh was used in the herniorrhaphy, the inguinal vas is often encompassed in fibrotic tissue, thus making reconstruction often impossible (3). The technique we have described gives access to healthy vasal tissue for reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Iatrogenic injury to the vas deferens is a well-documented complication of inguinal hernia repair (1,2). Recently obstruction related to the use of polypropylene mesh for hernia repair has been reported (3). We describe a case using laparoscopy to mobilize the retroperitoneal vas and deliver it to the healthy vas proximal to the vas trapped in the cicatrix induced by mesh, thus allowing a tension-free microsurgical repair.…”

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confidence: 99%