title: The long-term effect of mesh bioprosthesis in inguinal hernia repair on testicular nitric oxide metabolism and apoptosis in rat testis.
abstract: Polypropylene mesh is the most widely used material in inguinal hernia repair. Although polypropylene mesh is known as an inert material, it is experimentally proven that mesh generates a chronic inflammatory tissue reaction. The aim of the present study was to investigate the long-term effects of polypropylene mesh material used in inguinal hernia operations on testicular function, testicular nitric oxide (NO) metabolism and germ cell-specific apoptosis in rats. The study comprised 40 male rats that were randomly allocated into two groups. In group 1, the left spermatic cord was elevated and a 0.5 x 1 cm polypropylene mesh was placed behind the left inguinal spermatic cord and group 2 consisted of the sham-operated controls. Blood samples were taken at 6 months preoperatively and postoperatively after to assess luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels for hormonal evaluation. Testicular NO was evaluated by the Griess method, apoptosis by a TUNEL method and inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) expressions by immunohistochemical staining. Mild (+) eNOS expression was observed in all specimens. Mild (+) iNOS expression was only detected in ipsilateral testis of the mesh-implanted study group. Apoptotic cells were not detected in any samples. We are of the opinion that long-term polypropylene mesh implantation has no effect on testicular hormonal function and only a limited effect on nitric oxide levels and this effect is not sufficient to cause apoptosis in testis that could lead to infertility. It seems that mesh implantation is a reliable method in inguinal hernia repair; however, further work is required by more sensitive methods to fully elucidate the potential testicular damage.
authors.affiliation: Department of Biochemistry and Clinical Biochemistry, Celal Bayar University, Faculty of Medicine, Manisa, Turkey. fatma.taneli@bayar.edu.tr
authors.forename: Fatma
authors.initials: F
authors.lastname: Taneli
authors.forename: Hasan
authors.initials: H
authors.lastname: Aydede
authors.forename: Seda
authors.initials: S
authors.lastname: Vatansever
authors.forename: Cevval
authors.initials: C
authors.lastname: Ulman
authors.forename: Zeki
authors.initials: Z
authors.lastname: Ari
authors.forename: Bekir Sami
authors.initials: BS
authors.lastname: Uyanik
mesh_terms: D000818:Animals; D017209:Apoptosis; D006552:Hernia, Inguinal / Q000601:surgery*; D007248:Infertility, Male / Q000209:etiology; D007511:Ischemia / Q000378:metabolism / Q000473:pathology; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D011183:Postoperative Complications / Q000378:metabolism / Q000473:pathology; D019736:Prostheses and Implants; D051381:Rats; D011919:Rats, Inbred Strains; D013091:Spermatogenesis; D013526:Surgical Mesh; D013737:Testis / Q000378:metabolism* / Q000473:pathology
chemical_list: D009569:Nitric Oxide