Does the presence of a mesh have an effect on the testicular blood flow after surgical repair of indirect inguinal hernia?

• Published in: Journal of clinical ultrasound 2009-02, Vol.37 (2), p.78-81
• Main Authors: Ramadan, Selma Uysal, Gokharman, Dilek, Tuncbilek, Isil, Ozer, Hilal, Kosar, Pinar, Kacar, Mahmut, Temel, Selim, Kosar, Ugur
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arteries - diagnostic imaging; Arteries - pathology; Arteries - physiopathology; Blood Flow Velocity; Fibrosis - diagnostic imaging; Fibrosis - etiology; hernia; Hernia, Inguinal - surgery; Humans; inguinal; Male; mesh; Middle Aged; Postoperative Period; Prospective Studies; Prosthesis Implantation - adverse effects; Prosthesis Implantation - instrumentation; surgical; Surgical Mesh - adverse effects; Testis - blood supply; Testis - diagnostic imaging; Testis - pathology; Treatment Outcome; Ultrasonography, Doppler, Color; Venous Insufficiency - diagnostic imaging; Venous Insufficiency - etiology; Venous Insufficiency - physiopathology
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.20516

Purpose. Modern treatment of inguinal hernias includes prosthetic mesh repairs. However, direct contact of the mesh to the vessels in the inguinal canal and perimesh fibrosis may have a negative impact on testicular flow. The aim of this prospective study was to evaluate the effect of mesh implantation/perimesh fibrosis on testicular flow after repair of indirect inguinal hernias (IIHs). Method. Forty‐eight male patients with unilateral IIH were included. Both testicular parenchyma were assessed using gray‐scale sonography, and color/spectral Doppler sonography was performed to evaluate testicular arterial impedance, perfusion, and venous flow. Measurements were made bilaterally at the level of the inguinal canal 1 day before and at the end of the 2nd month after the operation. Results. There was no difference in testicular and echotexture perfusion between the hernia and the control sides pre‐ and postoperatively. No venous thrombosis was found. In all groups, resistance index and pulsatility index, measured at 4 levels, were highest in the proximal inguinal canal and lowest at the extratesticular–intrascrotal level (p < 0.05). For all Doppler parameters there was no significant difference between the pre‐ and postoperative measurements on both the hernia and the control sides. Conclusion. Mesh implantation/perimesh fibrosis does not adversely affect ipsilateral testicular flow. Mesh application is still a safe procedure in male patients in whom testicular function is important. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2009