title: Male infertility after mesh hernia repair: A prospective study.
abstract: BACKGROUND
  Several animal studies have raised concern about the risk for obstructive azoospermia owing to vasal fibrosis caused by the use of alloplastic mesh prosthesis in inguinal hernia repair. The aim of this study was to determine the prevalence of male infertility after bilateral mesh repair.
  
  
  METHODS
  In a prospective study, a questionnaire inquiring about involuntary childlessness, investigation for infertility and number of children was sent by mail to a group of 376 men aged 18-55 years, who had undergone bilateral mesh repair, identified in the Swedish Hernia Register (SHR). Questionnaires were also sent to 2 control groups, 1 consisting of 186 men from the SHR who had undergone bilateral repair without mesh, and 1 consisting of 383 men identified in the general population. The control group from the SHR was matched 2:1 for age and years elapsed since operation. The control group from the general population was matched 1:1 for age and marital status.
  
  
  RESULTS
  The overall response rate was 525 of 945 (56%). Method of approach (anterior or posterior), type of mesh, and testicular status at the time of the repair had no significant impact on the answers to the questions. Nor did subgroup analysis of the men ≤40 years old reveal any significant differences.
  
  
  CONCLUSIONS
  The results of this prospective study in men do not support the hypothesis that bilateral inguinal hernia repair with alloplastic mesh prosthesis causes male infertility at a significantly greater rate than those operated without mesh.
authors.affiliation: Department of Surgery, Clinical Sciences, Lund University and Lund University Hospital, Lund, Sweden. magnus.h@lsn.se
authors.forename: Magnus
authors.initials: M
authors.lastname: Hallén
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sandblom
authors.forename: Pär
authors.initials: P
authors.lastname: Nordin
authors.forename: Ulf
authors.initials: U
authors.lastname: Gunnarsson
authors.forename: Ulrik
authors.initials: U
authors.lastname: Kvist
authors.forename: Johan
authors.initials: J
authors.lastname: Westerdahl
mesh_terms: D000293:Adolescent; D000328:Adult; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*