title: Mechanism, assessment, and incidence of male infertility after inguinal hernia surgery: a review of the preclinical and clinical literature.
abstract: BACKGROUND
  The treatment of inguinal hernia has changed considerably over the past 15 years. We reviewed the preclinical and clinical literature to find out the effect of inguinal hernia surgery on male fertility because it has been suggested that hernia surgery may impair testicular function and male fertility.
  
  
  METHODS
  A search on Embase, MEDLINE, and the Cochrane Library was performed to find related articles.
  
  
  CONCLUSIONS
  Animal models show substantial effects of hernia repair on the structures in the spermatic cord, which is more pronounced in mesh repairs. Although the number of studies and the included numbers of patients were limited, clinical studies indicate that these potential adverse effects do not seem to have a clinical impact on male fertility in humans with inguinal hernias. Future clinical studies, preferably with bilateral patients, are necessary to investigate the clinical relevance of the effects of inguinal hernia and hernia surgery on male fertility.
authors.affiliation: Department of Surgery, Diakonessenhuis Utrecht/Zeist, Professor Lorentzlaan 76, Postbus 1002, 3700 BA Zeist, The Netherlands. htekatli@gmail.com
authors.forename: Hilâl
authors.initials: H
authors.lastname: Tekatli
authors.forename: Nelleke
authors.initials: N
authors.lastname: Schouten
authors.forename: Thijs
authors.initials: T
authors.lastname: van Dalen
authors.forename: Ine
authors.initials: I
authors.lastname: Burgmans
authors.forename: Niels
authors.initials: N
authors.lastname: Smakman
mesh_terms: D000818:Animals; D006552:Hernia, Inguinal / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D007248:Infertility, Male / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D007511:Ischemia / Q000209:etiology; D008297:Male; D023421:Models, Animal; D009920:Orchitis / Q000209:etiology; D010146:Pain / Q000209:etiology; D013085:Spermatic Cord / Q000098:blood supply / Q000293:injuries / Q000503:physiopathology; D013526:Surgical Mesh; D013737:Testis / Q000098:blood supply / Q000293:injuries / Q000503:physiopathology; D014649:Vas Deferens / Q000293:injuries / Q000503:physiopathology