COMPARATIVE ANALYSIS OF MEN FERTILITY WITH DIFFERENT METHODS OF HERNIOPLASTY

Abstract

Male infertility is a rare, but at the same time underestimated complication of inguinal hernia repair. Aim. To compare the results of hernia repair in reproductive men using transabdominal pre-peritoneal repair (TAPP) and the Lichtenstein method. Material and methods. The study involved 56 male patients aged 18 to 45 years who were operated on for a primary inguinal hernia. All patients were divided into two groups. The first group included 29 patients operated on using the Lichtenstein method. The second group included 27 patients operated on using the TAPP technique. Depending on the method of hernia repair, the following were studied: the dynamics of Doppler studies of testicular blood flow, the level of sex hormones in the blood plasma and spermogram before and after surgery. Results. The average percentage of sperm motility in the first group was 41.51±6.62 (median = 40%), and in the second group – 41.76±1.16 (median = 41%). The mean sperm count and motility were significantly higher in the second group (P < 0.001). The duration of the operation was significantly shorter in the first group, operated on using the Lichtenstein method, than in the second group, operated on using the TAPP technique (45.8 ± 6.28 vs. 68.5 ± 16.31 min; p < 0.001). According to the results of testicular ultrasound, the average volume of the right testicle in the first group was 14.19±3.16 (median = 14 ml), and in the second group – 14.68±3.07 ml (median = 14.8 ml). =12.15 ml), and in the second group – 14.25±3.19 (median = 14.40 ml), which turned out to be significantly lower in the observation group (p = 0.029). There was a significant difference between the two groups for postoperative dysesthesia and chronic pain: 5% in the TAPP group versus 14% in the Lichtenstein group, and 1.5% in the TAPP group versus 6% in the open group for chronic pain. Conclusion. There was no significant difference between the two groups in terms of intraoperative complications (p=0.56), short-term postoperative complications (p=0.75), wound infection (p=1.0), and urinary retention (p=0.68). However, treatment with the TAPP technique resulted in earlier hospital discharge, earlier return to normal activities, and optimal cosmetic results.