Year 2014 Vol. 22 No 5

GENERAL AND SPECIAL SURGERY

G.R. ASKERKHANOV1,2, F.M. AJTEKOVA1,3

IMPACT OF VARIOUS TYPES OF HERNIOPLASTY ON PATIENTS LIFE QUALITY AND FERTILITY

SBEE HPE Dagestan State Medical Academy 1,
OJSC Medical Centre named after R.P Askerkhanov 2,
SBE RD Republican Clinical Hospital of Makhachkala 3
The Russian Federation

Objectives. To study life quality and fertility of patients after various types of inguinal hernioplasty.
Methods. According to the hernioplasty method the patients were divided into three groups: the 1st group tension hernioplasty (n=116); the 2nd tension-free hernioplasty according to Lichtenstein method (n=288); the 3rd laparoscopic hernioplasty (n=44). To evaluate the effect of the inguinal hernioplasty on patients fertility parameters, 135 males aged 18-40 were randomly selected from the main group. Testing and examination were conducted preoperatively, 4 months and 1 year, postoperatively. The results of the study have been assessed prior surgery, after a median follow-up of 4 months and 1 year, postoperatively.
Results. Improvement of life quality parameters in the patients of the 3rd group reaches its maximum by the end of the 4th month postoperatively. The 2nd and 3rd patient groups achieve the same parameters by the end of the 12th month. The carried out research revealed that in the 1st group patients the reduction of sperm concentration up to 41,012,3 mln/mL can be observed, which is 2-folds less than the initial parameter. The relative number of mobile forms is also reduced by 10% of the original ratio. Negative changes in the 2nd group are less expressed than in the 1st group. The average concentration of sperm in a unit volume of ejaculate is reduced by 7,810,9 mln/ml, which is 9% from the baseline. By the end of the year of postoperative period, the reduction according this parameter continues approximately on 15,320,9 mln/mL, that is 15% of the initial parameter. Quality and quantity characteristics of ejaculate stay without negative dynamics in the 3rd group. On the contrary, the increase of the relative number of mobile spermatozoons has been registered by the end of the year.
Conclusions. Life quality after laparoscopic hernioplasty reaches its maximum by the end of the 4th month in comparison with the other methods. Laparoscopic hernioplasty has not worsened spermatogenesis parameters unlike the tension and tension-free hernioplasty.

Keywords: inguinal hernia, hernioplasty, quality of life, questionnaire MOS SF-36, spermogram, fertility
p. 538-546 of the original issue
References
  1. Novik AA, Ionova TI. Issledovanie kachestva zhizni v meditsine [The study of life quality in medicine]: uchebn. pos. Moscow, RF: GEOTAR-MED, 2004. 304 p.
  2. Novik AA, Ionova TI, red. Shevchenko IuL. Rukovodstvo po issledovaniiu kachestva zhizni v meditsine [A guide of the study of life quality in medicine]. 2e izdanie Moscow, RF: Olma Media Grupp, 2007. 320 p.
  3. Beltran MA, Cruces KS.Outcomes of Lichtenstein hernioplasty for primary and recurrent inguinal hernia. World J Surg. 2006 Dec;30(12):228187.
  4. Belokonev VI, Vavilov AV, Kovaleva ZV. Organizatsionnye printsipy raboty samarskogo gerniologicheskogo tsentra i ego problemy [Organizational principles of Samara herniological center and its problems]. Vestn Gerniologii. 2008. p.1517.
  5. Hallen M, Sandblom G, Nordin P, Gunnarsson U, Kvist U, Westerdahl J. Male infertility after mesh hernia repair: A prospective study. Surgery. 2011 Feb;149(2):17984.
  6. Skawran S. Obstructive azoospermia after bilateral endoscopic total extraperitoneal inguinal hernia repair - the role of surgeon.Hernia. 2009;1(13). 25 p.
  7. Miliukov VE, Kislenko AM. Profilaktika nekotorykh posleoperatsionnykh oslozhnenii pri pakhovoi gernioplastike traditsionnymi sposobami metodom intraoperatsionnoi verifikatsii i sokhraneniia nervnogo apparata pakhovoi oblasti [Prevention of some postoperative complications of inguinal hernioplasty by conventional methods of intraoperative verification and saving of nervous apparatus of inguinal area]. Annaly Khirurgii. 2005;(4):6671.
  8. Protasov AV, A.V. Krivtsov LM, Mikhaleva AV, Tabuika NIu. Shukhtin NIu. Vliianie setchatogo implantata na reproduktivnuiu funktsiiu pri pakhovoi gernioplastike [Influence of the mesh implant on reproductive function in inguinal hernioplasty] Khirurgiia im NI Pirogova. 2010;(8):2832.
  9. Gafarov UO, Povarikhina OA, Kuznetsov NA, Kharitonov SV. Vybor sposoba plastiki pri posleoperatsionnykh ventral'nykh gryzhakh [Choose the choice of plastics in postoperative ventral hernias]. Khirurg. 2008;(10):310.
Address for correspondence:
67000, Rossiyskaya Federatsiya, Respublika Dagestan,
g. Mahachkala, pl. Lenina d. 1,
GBOU VPO Dagestanskaya gosudarstvennaya meditsinskaya akademiya,
kafedra khirurgicheskih bolezney 1
mob. tel.: 8928 987-17-12,
e-mail: letom100@rambler.ru,
Ajtekova Fatima Mahmud-Pashaevna
Information about the authors:
Askerkhanov G.R. MD, professor, a head of the surgical diseases chair of SBEE HPE Dagestan State Medical Academy, general director of OJSC Medical Centre named after Askerkhanov R.P.
Ajtekova F.M. A lecturer of the surgical diseases chair of SBEE HPE Dagestan State Medical Academy, post-graduate student, clinical intern of the department of surgery of the abdominal cavity organs of SBE RD Republican Clinical Hospital of Makhachkala .
Contacts | ©Vitebsk State Medical University, 2007-2023