Vas deferens obstruction due to fibrosis after plug hernioplasty.
The positioning of mesh and plug is routinely performed in hernioplasty, but knowledge about the long-term side effects of plug-induced fibrosis on the vas is incomplete. This is the first case of a documented fibrotic vas deferens obstruction resulting from compression of the plug that was in direct contact with the vas. During subsequent repair for a recurrent hernia, the cord and the plug appeared enveloped in dense fibrous tissue. Microscopy confirmed gross surgical findings. To reduce this morbidity, we suggest a cremaster sparing surgery, avoiding the positioning of bioprosthesis in direct contact with the vas deferens. We also found that positioning of a flat mesh over the transversalis fascia will avoid the unnecessary contact between mesh and bare vas below the transversalis fascia.
Department of General Surgery, San Pietro Hospital-Fatebenefratelli, Rome, Italy.
Gabriele
G
Valenti
Emanuele
E
Baldassarre
Giovanni
G
Torino
D003251:Constriction, Pathologic / Q000209:etiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D005355:Fibrosis / Q000150:complications; D005832:Genital Diseases, Male / Q000209:etiology*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D014649:Vas Deferens / Q000473:pathology*