Study of testicular vascularity after totally extraperitoneal repair in inguinal hernia

Authors

  • Ashish Giri Department of General Surgery, VMMC and SJH, New Delhi, India
  • A. K. Sharma Department of General Surgery, VMMC and SJH, New Delhi, India
  • M. K. Mittal Department of Radiodiagnosis, VMMC and SJH, New Delhi, India
  • Ananta Ghimire Biomedical Data Scientist, Evidencian Research Associates, Bangalore, Karnataka, India
  • Dheer Singh Kalwaniya Department of General Surgery, VMMC and SJH, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20221148

Keywords:

Testicular vascularity, TEP, PSV, EDV, RI

Abstract

Background: Totally extra-peritoneal repair is one of the commonly used method for repair of inguinal hernia which is gaining popularity in recent days. Its effect on testicular vascularity has not been well established. The objective of this study was to study testicular vascularity following totally extra-peritoneal repair [TEP] in inguinal hernia.

Methods: This study was prospective observational study performed on patients with inguinal hernia undergoing TEP where testicular USG doppler parameters like peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI) and pulsatilty index (PI) were measured on pre-operative day, on 3rd postoperative day and 90th postoperative day, and serum values of FSH, LH and Testosterone were measured preoperatively and 90th postoperative day and these values were compared.

Results: 42 patients were included in this study. There was no statistically significant difference in the values of PSV (p=0.497), EDV (p=0.981), RI (p=0.290) and PI (p=0.733) between preoperative value, 3rd postoperative day, and 90th postoperative day. There was no statistically significant difference in the serum values of FSH (p=0.376), LH (p=0.101) and Testosterone (p=0.506) between preoperative and 90th postoperative day level.

Conclusions: It was concluded that totally extra-peritoneal repair (TEP) do not affect testicular perfusion. However large scale multi-institute trails with bigger sample size is required to find out effect of TEP on testicular vascularity.

 

References

Fitzgibbons RJ Jr, Forse RA. Clinical practice. Groin hernias in adults. N Engl J Med. 2015;372(8):756-63.

Karthikesalingam A, Markar SR, Holt PJ, Praseedom RK. Metaanalysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. BrSurg. 2010;97:4-11.

Voeller GR, Mangiante EC. Totally preperitoneal laparoscopic inguinal herniorrhaphy using balloon distention. Scand J Gastroenterol. 1995;30(208):67-73.

Karthikesalingam A, Markar SR, Holt PJ, Praseedom RK. Metaanalysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. BrSurg. 2010;97:4-11.

Ferzli G, Iskandar M. Laparoscopic totally extra-peritoneal (TEP) inguinal hernia repair. Ann Laparosc Endosc Surg. 2019;4(0):35-5.

Middleton WD, Thorne DA, Melson GL. Color Doppler ultrasound of the normal testis. AJR Am J Roentgenol. 1989;152(2):293-7.

Fatima A, Mohiuddin MR. Study of incidence of inguinal hernias and the risk factors associated with the inguinal hernias in the regional population of a South Indian City. Int J Cur Res Rev. 2014;6(23):9-13.

Roos MM, Clevers GJ, Verleisdonk EJ, Davids PH, van de Water C, Spermon RJ, et al. Bilateral endoscopic totally extraperitoneal (TEP) inguinal hernia repair does not impair male fertility. Hernia. 2017;21(6):887-94.

Akbulut G, Serteser M, Yücel A, Değirmenci B, Yilmaz S, Polat C, et al. Can laparoscopic hernia repair alter function and volume of testis?: Randomized clinical trial. Surg Laparosc Endosc Percutan Tech. 2003;13(6):377-81.

Štula I, Družijanić N, Sapunar A, Perko Z, Bošnjak N, Kraljević D. Antisperm antibodies and testicular blood flow after inguinal hernia mesh repair. Surg Endosc. 2014;28(12):3413-20.

Gangopadhyay A, Ghosh BC. Is laparoscopic totally extra peritoneal repair of hernia (TEP) superior than trans-abdominal preperitoneal (TAAP) mesh repair of inguinal hernia- our experience from a tertiary care hospital, Kolkata. Asian J Med Sci. 2018;9(6):20-4.

Peeters E, Spiessens C, Oyen R, De Wever L, Vanderschueren D, Penninckx F et al. Sperm motility after laparoscopic inguinal hernia repair with lightweight meshes: 3-year follow-up of a randomised clinical trial. Hernia. 2014;18(3):361-7.

Downloads

Published

2022-04-26

Issue

Section

Original Research Articles