The effects of Lichtenstein tension-free mesh hernia repair on testicular arterial perfusion and sexual functions

Lichtenstein tension-free mesh hernia repair has been gold standard for treatment of inguinal hernia. Studies have demonstrated that the complication rate is low. However, because the structures in spermatic cord pass through a narrow space, there has been concern about injury to testicular artery, vein, and vas deferens. The aim of this study was to evaluate the effects of Lichtenstein tension-free mesh hernia repair on testicular arterial perfusion and sexual functions in early phase after the operation. Forty male patients underwent tension-free mesh hernia repair. All of them underwent Lichtenstein tension-free mesh hernia repair under spinal anesthesia. Patients were evaluated for local wound complications such as seroma, hematoma, and infection on days 1 and 7. To evaluate the effects of surgery on sexual activity, pain was graded on a scale of 1 to 10 by visual analog scale (VAS). International Index of Erectile Dysfunction (IIEF-5) questionnaire was used in our study to evaluate sexual dysfunction. Testicular arterial flow was reevaluated by Doppler ultrasound. Patients were questioned about erectile dysfunction and sexual satisfaction as well as pain limiting their daily activities and sexual function. Mean operation time was 38 +/- 5 (23-122) minutes. Preoperative/postoperative mean flow velocity for operation side (ipsilateral) was 5.13 +/- 2.7 ml/min and 6.3 +/- 2.3 ml/min respectively and the difference was statistically significant (p = 0.008). VAS scores in preoperative and postoperative periods were compared and had mean values of 0.6 +/- 1.4 and 0.8 +/- 1.7 respectively and the difference was not statistically significant. Lichtenstein tension-free mesh hernia repair does not have any negative effects on testicular perfusion and sexual function; it can be performed safely for treatment of inguinal hernia.