Abstract
3 21-year-old man was evaluated for a symptomatic, educible left inguinal hernia. He denied any urinary or bdominal symptoms. His history was significant only or an uneventful, right open inguinal hernia repair 1 ear earlier. On examination, the patient had an easily educible, moderate-sized, left inguinal hernia and a ormal testicular exam. At operative exploration, an indirect hernia was idenified. During dissection of the hernia sac from adjacent ord structures, we isolated two separate, equal-sized vas eferens (A). Intraoperative examination of the scrotum emonstrated a single testicle and epididymis. Care was aken to keep both structures intact during high ligation f the hernia sac and while suturing the mesh into place B). The patient tolerated the procedure well and had an ncomplicated postoperative course. Injury to the vas deferens is a recognized complication fter inguinal herniorrhaphy that may lead to infertility, hronic pain, and spermatic granulomas. Identificaion of the vas deferens during exploration of the cord or a hernia sac prevents iatrogenic injury. In patients ith a unilateral duplicated vas deferens, this anatomic
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