title: Sperm motility after laparoscopic inguinal hernia repair with lightweight meshes: 3-year follow-up of a randomised clinical trial.
abstract: OBJECTIVE
  To analyse the effects of lightweight meshes in laparoscopic inguinal hernia repair on male fertility aspects, chronic pain development and recurrence at 3-year follow-up.
  
  
  METHODS
  Fifty-nine male patients with a primary, unilateral or bilateral inguinal hernia were randomised to laparoscopic inguinal hernia repair using a standard polypropylene (Marlex(®)) or lightweight mesh (VyproII(®), TiMesh(®)). Patients attended clinical follow-up 3 years postoperatively, at which male fertility aspects, by semen analysis and scrotal ultrasound, chronic pain status (McGill Pain Questionnaire), quality of life (SF-36) and recurrence were assessed, or completed quality of life, pain and hernia-specific questionnaires at home.
  
  
  RESULTS
  In total, 49 patients (83.1 %) completed follow-up (median follow-up = 39.1 months), by questionnaire and/or clinical follow-up. As other semen parameters and scrotal ultrasound results, sperm motility was unchanged compared to 1 year postoperatively, but not significantly different between VyproII(®) and TiMesh(®) versus Marlex(®) patients (-8.5 % and -8 % vs. -2.8 %; P = 0.23). Pain perception and quality of life were comparable between the heavyweight and lightweight groups, and no change was noted in comparison with 1 year postoperatively. Chronic pain incidence was 6.1 % (3 patients), without occurrence of disabling pain. Three patients were clinically diagnosed with a recurrent hernia (5.9 %).
  
  
  CONCLUSIONS
  The decrease in sperm motility in patients operated on with a lightweight mesh compared to patients operated on with a heavyweight mesh 1 year after laparoscopic inguinal hernia repair could not be confirmed at 3 years follow-up. Furthermore, heavyweight and lightweight groups were comparable regarding quality of life, chronic pain and recurrence rate.
authors.affiliation: Department of Abdominal Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium, ellen.peeters@med.kuleuven.be.
authors.forename: E
authors.initials: E
authors.lastname: Peeters
authors.forename: C
authors.initials: C
authors.lastname: Spiessens
authors.forename: R
authors.initials: R
authors.lastname: Oyen
authors.forename: L
authors.initials: L
authors.lastname: De Wever
authors.forename: D
authors.initials: D
authors.lastname: Vanderschueren
authors.forename: F
authors.initials: F
authors.lastname: Penninckx
authors.forename: M
authors.initials: M
authors.lastname: Miserez
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000209:etiology; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012008:Recurrence; D013081:Sperm Motility; D013526:Surgical Mesh; D055815:Young Adult