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Surgical Endoscopy

Published in:

01-12-2014

Antisperm antibodies and testicular blood flow after inguinal hernia mesh repair

Authors: Ivana Štula, Nikica Družijanić, Ada Sapunar, Zdravko Perko, Nada Bošnjak, Damir Kraljević

Published in: Surgical Endoscopy | Issue 12/2014

Abstract

Background

Testicular flow studies after hernia mesh repair mostly showed different outcomes. The reason of infertility in some men after hernia repair is immunological factors. Aim of the study was to investigate the influence of mesh hernia repair on antisperm antibodies production and testicular blood flow and a connection among these parameters.

Materials and methods

A prospective interventional longitudinal cohort study was made on 82 male patients without exclusion criteria who had an inguinal hernia. Patients underwent laparoscopic TAPP or open tension-free hernia repair. Vascular ultrasound and antisperm antibodies were measured in the preoperative and postoperative periods. Main outcome measures were resistive index (RI), peak systolic velocity (PSV) cm/s, and end-diastolic velocity (EDV) cm/s in testicular blood flow measurement and the quantitative value of antisperm antibodies (ASA) in serum (IU/ml).

Results

ASA significantly increased postoperatively only in patients who underwent open tension-free hernia repair (p < 0.001). ASA stayed in normal range in all patients except the one with postoperative complication. Friedman analysis showed significant change of the RI only on intratesticular (p < 0.001) and capsular artery level (0.02) in patients who underwent laparoscopic technique. PSV significantly changed on intratesticular (p < 0.001) and capsular artery level (p = 0.015) in the laparoscopic hernia repair. PSV showed significant change on intratesticular (p < 0.001) and testicular artery levels (p < 0.001) in the open tension-free hernia repair. EDV showed significant change only on testicular artery level (p = 0.032) in the patients who had open tension-free hernia repair. These blood flow parameters significantly increased in the early postoperative period and returned on basal value in the late postoperative period. Parameters of flow did not show any significant correlation with ASA.

Conclusion

Mesh hernia repairs without complication caused only a transitory change in testicular blood flow and no clinical significant autoimmune reaction.

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Title: Antisperm antibodies and testicular blood flow after inguinal hernia mesh repair
Authors: Ivana Štula
Nikica Družijanić
Ada Sapunar
Zdravko Perko
Nada Bošnjak
Damir Kraljević
Publication date: 01-12-2014
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 12/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3614-7

At a glance: The STEP trials

Springer Medicine

Antisperm antibodies and testicular blood flow after inguinal hernia mesh repair

Abstract

Background

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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