The Choice of Synthetic Mesh to Surgical Treatment by I.L.Lichtenstein of Inguinal Hernia

Abstract

Relevance The basic technique of inguinal hernia repair is Lichtenstein procedure. This operation based on prosthetic repair of posterior wall of inguinal canal. The question of male infertility after Lichtenstein repair is to date known. The recommendations to choice of synthetic mesh for surgical treatment of inguinal hernia in males are to date not presented. The purpose of study is the choice of synthetic mesh for inguinal hernia repair in males. Materials and methods There was performed the simulation of Lichtenstein plasty in rabbits. The standard polypropylene (PP Std), light polypropylene (PP Light), polyvinylidene fluoride (PVDF) and reperene (R) meshes were used. Area of implantation was explored in 3 – 6 months. Macroscopic changes were estimated by special score. The data were by Mann – Whitney analyzed. Results and their discussion The maximal scar process was associated with PP Std. Medium scar process was noted after PP Light implantation. Minimal scar connective tissue was observed after PVDF plasty, but lower – in R cases (p=0,018). Conclusion We marked than after PP Std plasty strong scars developed with involvement of ductus deferens. This phenomenon is a base for ductus deferens obliteration, obstructive azoospermia and male’s infertility. The routine use of PP Std meshes to the Lichtenstein technique in young males with inguinal hernias is inadvisable. The possibility of PP Light use need of further researches. Some good results are associated with PVDF and R implantation