Evaluation of Testicular Function after Laparoscopic and Open Mesh Repair of Inguinal Hernia

Özet

Objective: The aim of this study was to compare the effects on testicular volume (TV) and spermatic cord blood flow of Lichtenstein hernia repair using tension-free synthetic mesh and laparoscopic totally extraperitoneal (TEP) repair. Methods: A total of 96 sexually active male patients aged 20–40 years who presented at a general surgery outpatient clinic between January 2018 and June 2019 and were diagnosed with inguinal hernia were included in the study. The patients were randomized into 2 groups. Of the group, 48 patients underwent Lichtenstein hernioplasty (Group I) and 48 patients had TEP repair (Group II). Inguinal Doppler ultrasound was performed 1 year after surgery to evaluate the operated side and to assess the intact testicular volume and spermatic cord arterial blood flow. The peak systolic velocity (Vmax), end diastolic velocity (Vmin), resistive index (RI), and pulsatility index (PI) were measured. Results: A statistically significant difference was found in the Vmin, RI, PI, and TV values in the Lichtenstein repair side (Group I) in comparison with the non-operated side (p=0.03, 0.01, 0.01, 0.01, respectively). In the comparison of the TEP repair side (Group II) with the non-operated side, no statistically significant difference was observed in the TV or spermatic cord arterial blood flow values. While there was no significant difference between Vmax, Vmin, and TV values between the Lichtenstein and TEP groups, a statistically significant difference was seen in the RI and PI values (p=0.02, 0.01, respectively). Conclusion: In this evaluation of the effects of surgical treatment of inguinal hernia, TEP repair provided better preservation of testicular function compared with the Lichtenstein technique.