Year 2014 Vol. 22 No 3

EXCHANGE OF EXPERIENCE

T.K. GVENETADZE1, G.T. GIORGOBIANI1 2, V.SH. ARCHVADZE1, L.O. GULBANI3

PREVENTION OF MALE INFERTILITY DEVELOPMENT AFTER DIFFERENT METHODS OF INGUINAL HERNIA REPAIR WITH THE MESH EXPLANT

Tbilisi State Medical University 1,
“Aversi Clinic” 2, Tbilisi
Georgia,
SEE “Belarusian Medical Academy of Post-Graduate Education” 3, Minsk,
The Republic of Belarus

Objectives. The study and comparison of quantitative composition of spermatozoids prior and after Lichtenstein and Gvenetadze operations.
Methods. For the recent 6 years 1000 patients have been operated on by the isolation method. 215 patients of the reproductive age (19-40 yrs.) with the bilateral inguinal hernias became the object of study. The patients were allocated into two groups. The first group contained those 66 patients (30,7%) who underwent bilateral Lichtenshtein hernia repair. The second group – 149 patients (69,3%) on whom bilateral hernia repairs by Gvenetadze method have been utilized. Complete spermomorphocitological investigations have been performed in all groups 2 days prior to surgery, 30 days and six months after surgery.
Results. Oligospermia, reduction of the quantitative sperm composition by 30-35% was revealed only in the first group (p<0,01). In the second group no significant differences was registered. 68 patients had children after surgery by Gvenetadze method.
Conclusions. Hernioplasty by Gvenetadze prevents male infertility in all cases especially for bilateral inguinal hernia repair as well as in reproductive age. The given technique is more solid as the posterior wall of the inguinal canal presented by the transverse fascia, mesh and aponeurosis of the external oblique muscle therefore the recurrence rates of hernia is minimized and practically excluded. Based on the foregoing results this method is considered as an effective method of hernioplasty as for young as well for elderly patients.

Keywords: inguinal hernia, spermatic cord isolation, mesh material
p. 379 – 385 of the original issue
References
  1. Hallen M, Nordin P. Westerdahl J, Gwereman (et al) Does mesh repair of groin hernia cause male infertility? Hernia 2009 1(13):25.
  2. Klosterhalfen B, Klinge U, Schumpelick V. Functional and morphological evaluation of different polypropylene-mesh modifications for abdominal wall repair. Biomaterials. 1998;(19):2235–46.
  3. Le blank KA, Booth WV, Whitaker JM, Baker D (1998) In vivo study of meshes implanted over the inguinal ring and external iliac vessels in uncastrated pigs. Surg Endosc. 1998 Mar;12(3):247–51.
  4. Shin D1, Lipshultz LI, Goldstein M, Barme GA, Fuchs EF, Nagler HM, McCallum SW, Niederberger CS, Schoor RA, Brugh VM 3rd, Honig SC.Herniorrhaphy with polypropylene mesh causing inguinal vasal obstruction: a preventable cause of obstructive azoospermia. Ann Surg. 2005 Apr;241(4):553–58.
  5. Skawran S., Schmits B, Weghe D. Obstructive azoospermia after bilateral endoscopy total extra peritonial inguinal hernia repair- the role of surgeon. Hernia 2009 1(13):25.
  6. Uzzo RG1, Lemack GE, Morrissey KP, Goldstein M. The effects of mesh bioprosthesis on the spermatic cord structures: a preliminary report in a canine model. J Urol. 1999 Apr;161(4):1344–49.
  7. Peiper C1, Junge K, Klinge U, Strehlau E, Ottinger A, Schumpelick V. Is there a risk of infertility after inguinal mesh repair? Experimental studies in the pig and the rabbit. Hernia. 2006 Mar;10(1):7–12.
  8. Peiper Ch1, Klinge U, Junge K, Schumpelick V. Meshes in inguinal hernia repair. Zentralbl Chir. 2002 Jul;127(7):573–77. [Article in German]
  9. Egiev VN. Nenatiazhnaia gernioplastika [Tension -freel hernioplastics]. Moscow, RF; Medpraktika, 2002. 147 p.
  10. Stupin VA, Laptev VV, Mikhailusov SV, Saibulaev SA, Dzhafarov ET. Vybor metoda khirurgicheskogo lecheniia pakhovykh gryzh [The choice of surgical treatment method of inguinal hernias]. Khirurgiia, 2009;(11):53–57.
  11. Timoshin AD, Iurasov AV, Shestakov AL. Khirurgicheskoe lechenie pakhovykh i posleoperatsionnykh gryzh briushnoi stenki [Surgical treatment of postoperative inguinal and abdominal wall hernias]. Moscow, RF: Triada X, 2003. 144 P.
  12. Trabucco E. Atlas of herniology. Turin, 2006, p.44.
  13. Trabucco E, Companelli GP, Cavagnoli R. New polypropylene hernia prosthesis. Minerva Chir. 1998 Apr;53(4):337–41.
Address for correspondence:
0160, Gruziya, g. Tbilisi, pr. Vazha-Pshavela, d. 27 b, Klinika «Aversi»,
e-mail: surgeontg@Yahoo.com,
Gvenetadze Tamaz Kalenikovich
Information about the authors:
Gvenetadze T.K. MD, professor of the emergency surgery chair ¹2 of Tbilisi State Medical University.
Giorgobiani G.T. MD, professor, a head of the emergency surgery chair ¹2 of Tbilisi State Medical University, clinical director of “Aversi Clinic”.
Archvadze V.Sh. MD, professor of the general surgery chair of Tbilisi State Medical University.
Gulbani L.O. A clinical intern of the surgery chair of SEE “Belarusian Medical Academy of Post-graduate education”.
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