Transabdominal preperitoneal hernioplasty for inguinal hernia and male fertility

Abstract

Objective Inguinal hernia is a common surgical problem. Spermatic cord structures may be injured during open hernia repair, but it is uncommon after laparoscopic repair. Aim The aim was to study transabdominal preperitoneal (TAPP) inguinal hernioplasty and its effect on fertility in male patients. Patients and methods From July 2015 to November 2017, 30 male patients underwent laparoscopic TAPP inguinal hernioplasty and were included in this study. Testicular duplex and semen analysis were done preoperatively and 3 and 6 months postoperatively. Results Preoperative sperm count and motility were within normal ranges. Three months postoperatively, there was a decrease in sperm count in five (16.7%) patients and decreased sperm motility in three (10%) patients. Further three months later, sperm count returned to normal ranges in all patients, and sperm motility returned to normal ranges in two (6.7%) patients but still decreased in one (3.3%) patient. Regarding testicular duplex, arterial flow was normal in all patients preoperatively; 3 months later, there was a decreased arterial flow in two (6.7%) patients; and 6 months postoperatively, testicular arterial flow returned to normal. Conclusion Laparoscopic TAPP hernioplasty is feasible, is easy to learn, and has good results. Postoperatively, there was no significant affection of testicular perfusion or sperm characteristics.

Keywords

• fertility
• inguinal hernia
• transabdominal preperitoneal