Abstract:
Background. Inguinal wall reinforcement with a synthetic mesh remains a gold standard therapy for a hernia with
good clinical outcomes; however, presence of a prosthetic
material close to the spermatic cord may influence male
fertility due to vas deferens obstruction. Objective of the
study. The aim of this study was to analyze the long-lasting
impact of different hernioplasty techniques on sexual function. Material and methods. A bibliographic search for
specialized free available English literature was performed
in PubMed database according to the MeSH terms: “inguinal hernia”, “prosthetic mesh”, “sexual function”, “fertility”,
article type – clinical trial, publication period – 2010-2024.
Results. A total of 5 trials comparing the outcome of laparoscopic and open surgeries for groin hernia repair were
assessed. The randomized clinical trials comparing open
(Lichtenstein tension-free) vs laparoscopic (TAPP or TEP)
approaches demonstrated no sexual changes in the groups with a significant positive impact in terms of fertility indices
determined by the improvement in testicular vascularity,
physical function, emotional aspects, bodily pain, and general health. The trial CTRI/2018/05/013,621 comparing
laparoscopic repair TAPP vs TEP showed statistically significant amelioration in overall sexual function score and
failed to identify differences between the groups depending
on the technique. A Belgian randomized trial NCT00925067
aimed to evaluate the effects of lightweight vs heavyweight
meshes. Even lightweight meshes are supposed to be more
biocompatible due to lower body reaction and less fibrosis,
they had no advantages with regard to semen analysis registered within 3 year follow-up. Conclusion. The studies have
shown that inguinal hernia repair leads on to improvement
in sexual functions and fertility indices with no significant
differences based on surgical approach or synthetic mesh
type.
