Many of our male patients ask about preservation of their fertility after hernia repair. Clearly with unilateral (one sided) hernia repair, the incidence of infertility is zero. However, with bilateral hernia repairs, patients sometimes worry about becoming infertile.
Endoscopic totally extraperitoneal (TEP) hernia repair with polypropylene mesh has become a well-established technique. However, since the mesh is placed in close contact with the spermatic cord, mesh-induced inflammation may affect its structures, possibly resulting in impaired fertility. The aim of this observational prospective cohort study was to assess fertility after bilateral endoscopic TEP inguinal hernia repair in male patients.
This study data suggest that bilateral endoscopic TEP hernia repair with polypropylene mesh does not impair fertility, as no differences in testicular blood flow, testicular volume, or semen quality were observed. Postoperative levels of LH and inhibin B differed significantly from pre- operative measurements, yet no clinical relevance could be ascribed to these findings.
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