Bilateral inguinal hernia repair and male fertility: a randomized clinical trial comparing Lichtenstein versus laparoscopic transabdominal preperitoneal (TAPP) technique

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorDAMOUS, Sergio Henrique Bastos
dc.contributor.authorDAMOUS, Luciana Lamarao
dc.contributor.authorBORGES, Victor Andre
dc.contributor.authorFONTELLA, Amanda Karsburg
dc.contributor.authorMIRANDA, Jocielle dos Santos
dc.contributor.authorKOIKE, Marcia Kiyomi
dc.contributor.authorSAITO, Osmar Cassio
dc.contributor.authorBIROLINI, Claudio Augusto Vianna
dc.contributor.authorUTIYAMA, Edivaldo Massazo
dc.date.accessioned2024-04-05T19:26:56Z
dc.date.available2024-04-05T19:26:56Z
dc.date.issued2023
dc.description.abstractBackground The effects of hernia repair on testicular function remain uncertain, regardless of the technique used. Studies that analyze testicular volume and flow after hernia repair or hormonal measurements are scarce and show contradictory results. This study aimed to evaluate the impact of bilateral inguinal hernia repair on male fertility in surgical patients in whom the Lichtenstein and laparoscopic transabdominal preperitoneal (TAPP) techniques were used.Methods A randomized clinical trial comparing open (Lichtenstein) versus laparoscopic (TAPP) hernia repair using polypropylene mesh was performed in 48 adult patients (20 to 60 years old) with primary bilateral inguinal hernia. Patients were evaluated preoperatively and 90 and 180 postoperative (PO) days. Sex hormones (Testosterone, FSH, LH and SHGB) analysis, testicular ultrasonography, semen quality sexual activity changes and quality of life (QoL) were performed. Postoperative pain was evaluated using the visual analog scale (VAS).Results Thirty-seven patients with aged of 44 +/- 11 years were included, 19 operated on Lichtenstein and 18 operated on TAPP. The surgical time was similar between techniques. The pain was greater in the Lichtenstein group on the 7th PO day. The biochemical and hormonal analyses, testicular ultrasonography (Doppler, testicular volume, and morphological findings) and sperm quality were similar between groups. However, the sperm morphology was better in the Lichtenstein group after 180 days (p < 0.05 vs. preoperative) and two patients who underwent Lichtenstein hernia repair had oligospermia after 180 days. The QoL evaluation showed a significant improvement after surgery in the following domains: physical function, role emotional, bodily pain and general health (p < 0.05). On comparison of Lichtenstein vs. TAPP none of the domains showed statistically significant differences. No patient reported sexual changes.Conclusion Bilateral inguinal hernia repair with polypropylene mesh, whether using Lichtenstein or TAPP, does not impair male fertility in terms of long-term outcomes.Trial registration: Approved by the Ethics Committee for the Analysis of Research Projects (CAPPesq) of the HC/FMUSP, Number 2.974.457, in June 2015, Registered on Plataforma Brasil in October 2015 under Protocol 45535015.4.0000.0068. Registered on Clinicaltrials.gov, NCT 05799742. Enrollment of the first subject in January 2016.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexScopus
dc.description.indexDimensions
dc.description.indexWoS
dc.description.sponsorshipWe thank Toshiko Oya for help with data collection.
dc.identifier.citationSURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.37, n.12, p.9263-9274, 2023
dc.identifier.doi10.1007/s00464-023-10499-8
dc.identifier.eissn1432-2218
dc.identifier.issn0930-2794
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58731
dc.language.isoeng
dc.publisherSPRINGEReng
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniques
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGEReng
dc.subjectInguinal herniaeng
dc.subjectHernia repaireng
dc.subjectInfertilityeng
dc.subjectPolypropylene mesheng
dc.subjectLichtensteineng
dc.subjectLaparoscopyeng
dc.subjectTAPPeng
dc.subject.otherquality-of-lifeeng
dc.subject.otherpolypropylene mesheng
dc.subject.othertesticular functionseng
dc.subject.otherspermatic cordeng
dc.subject.otherblood-floweng
dc.subject.othervolumeeng
dc.subject.otherherniorrhaphyeng
dc.subject.otherobstructioneng
dc.subject.othersurgeryeng
dc.subject.otherdamageeng
dc.subject.wosSurgeryeng
dc.titleBilateral inguinal hernia repair and male fertility: a randomized clinical trial comparing Lichtenstein versus laparoscopic transabdominal preperitoneal (TAPP) techniqueeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcSERGIO HENRIQUE BASTOS DAMOUS
hcfmusp.contributor.author-fmusphcLUCIANA LAMARAO DAMOUS
hcfmusp.contributor.author-fmusphcVICTOR ANDRE BORGES
hcfmusp.contributor.author-fmusphcAMANDA KARSBURG FONTELLA
hcfmusp.contributor.author-fmusphcJOCIELLE SANTOS DE MIRANDA
hcfmusp.contributor.author-fmusphcMARCIA KIYOMI KOIKE
hcfmusp.contributor.author-fmusphcOSMAR DE CASSIO SAITO
hcfmusp.contributor.author-fmusphcCLAUDIO AUGUSTO VIANNA BIROLINI
hcfmusp.contributor.author-fmusphcEDIVALDO MASSAZO UTIYAMA
hcfmusp.description.beginpage9263
hcfmusp.description.endpage9274
hcfmusp.description.issue12
hcfmusp.description.volume37
hcfmusp.origemWOS
hcfmusp.origem.dimensionspub.1165225526
hcfmusp.origem.pubmed37880447
hcfmusp.origem.scopus2-s2.0-85174697421
hcfmusp.origem.wosWOS:001088793400002
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUNITED STATESeng
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