Inguinal hernia repair protects testicular function: a prospective study of open and laparoscopic herniorraphy.
BACKGROUND
Despite the frequency of open and laparoscopic herniorraphy the effect of the hernia and subsequent repair on testicular function is unknown. Our objective was to determine if there is an association between inguinal hernia and hernia repair on testicular function.


METHODS
Thirty-seven men aged 18 to 70 years were enrolled in a prospective internally controlled cohort study. They underwent Doppler ultrasonography and serum testicular hormone analysis pre- and post- either open Lichtenstein's repair or laparoscopic totally extraperitoneal hernioplasty. These surrogates of testicular function were measured up to 6 months postrepair.


RESULTS
Thirty-seven consecutive patients underwent either Lichtenstein (n = 17) or totally extraperitoneal hernioplasty (n = 20) hernia repair as per surgeon preference. Preoperatively there was a significant elevation in the sonographic resistive index (RI) in the affected (hernia) side compared with the normal side (0.601, 0.569; p < 0.001). This elevation in RI was reversed posthernia repair at a median followup of 6.1 months. Inguinal hernia or repair did not affect testicular volume. The choice of either Lichtenstein or totally extraperitoneal hernioplasty hernia did not significantly alter the testicular function.


CONCLUSIONS
Patients with inguinal hernia have an elevated testicular vascular resistance, which is reversed after repair. The choice of laparoscopic or open herniorraphy did not affect reversal of this surrogate of testicular function.
Beddy
Peter
P
Department of Surgery, Trinity College Dublin, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
Ridgway
Paul F
PF
Geoghegan
Tony
T
Peirce
Colin
C
Govender
Pradeep
P
Keane
Francis B V
FB
Torreggiani
William C
WC
Conlon
Kevin C P
KC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D013737:Testis / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D014655:Vascular Resistance / Q000502:physiology