Male reproductive status after the classical inguinal hernia repair

Abstract

Aim. To determine the male reproductive status 18-20 years after classic unilateral herniotomy performed in childhood. Methods. Newsletters were sent to 127 patients, of whom 12 (9.45 %) responded. Male patients were invited for examination, including physical examination spermography with mixed agglutination reaction (MAR)-test, scrotum Doppler ultrasonography, prostate ultrasonography. Complete list of abovementioned examinations was performed in 10 male patients, representing 7.87% of the total number of respondents. 10 volunteers who had no medical history of inguinal hernia surgery were tested as a comparison group. Results. Sclerotic changes manifesting as testicular calcification were found in 4 (3.15%) patients who underwent inguinal hernioplasty surgery. No such findings were registered in volunteers who had no inguinal hernia surgery. Besides, 4 patients developed unilateral testicular hypotrophy of the hernia side, accompanied by an increased resistance index of parenchymal vessels in 75% of cases, which indirectly explains the causes of pathological changes in sperm. Considering small number of examined patients, the study had not enough power to state that hernioplasty surgery had the negative impact on male reproductive function; hence, it should be noted that in 7 cases alterations in the semen analysis were found, and 3 patients were infertile. These changes are likely to be related to technical defects of classic inguinal hernioplasty surgery performed in childhood. Conclusion. It is necessary to revise the use of classic inguinal hernioplasty and herniorrhaphy surgery performed in male children.