Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study.
BACKGROUND
Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual activity after laparoscopic inguinal herniorrhaphy on a nationwide basis.


METHODS
The study population comprised all men aged 18-50 years registered in the Danish Hernia Database (n = 1,671) who underwent primary laparoscopic herniorrhaphy between January 1, 1998 and November 30, 2009. Questionnaires regarding dysejaculation and pain during sexual activity were mailed 3 months to 12 years after surgery, and 1,172 patients were included for analysis.


RESULTS
The response rate was 68.7% (n = 805). Dysejaculation occurring after laparoscopic repair was present in 25 patients (3.1%). Pain from the groin or genitals during sexual activity was reported by 88 patients (10.9%), and 19 patients (2.4%) reported that the pain had impaired their sexual activity to a moderate or severe degree. Older patients and patients with longer follow-up had lower prevalence of pain during sexual activity.


CONCLUSIONS
Dysejaculation and pain-related impairment of sexual activity is a significant problem after laparoscopic inguinal herniorrhaphy. The role of improved laparoscopic technique with use of glue fixation of lightweight meshes to reduce the risk of developing these complications needs to be evaluated.
Section of Surgical Pathophysiology 4074, Rigshospitalet, Copenhagen University, Blegdamsvej 9, 2100, Copenhagen, Denmark. joakim.mutahi.bischoff@rh.regionh.dk
Joakim M
JM
Bischoff
Gitte
G
Linderoth
Eske Kvanner
EK
Aasvang
Mads U
MU
Werner
Henrik
H
Kehlet
D000293:Adolescent; D000328:Adult; D004414:Dyspareunia / Q000209:etiology* / Q000503:physiopathology; D004542:Ejaculation / Q000502:physiology*; D006552:Hernia, Inguinal / Q000503:physiopathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D055815:Young Adult