Department of Surgery, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
Surgery. 2012 Jan;151(1):94-8. doi: 10.1016/j.surg.2011.06.028. Epub 2011 Sep 22.
Previous studies have suggested that the use of mesh in groin hernia repair may be associated with an increased risk for male infertility as a result of inflammatory obliteration of structures in the spermatic cord. In a recent study, we could not find an increased incidence of involuntary childlessness. The aim of this study was to evaluate this issue further.
Men born between 1950 and 1989, with a hernia repair registered in the Swedish Hernia Register between 1992 and 2007 were cross-linked with all men in the same age group with the diagnosis of male infertility according to the Swedish National Patient Register. The cumulative and expected incidences of infertility were analyzed. Separate multivariate logistic analyses, adjusted for age and years elapsed since the first repair, were performed for men with unilateral and bilateral repair, respectively.
Overall, 34,267 men were identified with a history of at least 1 inguinal hernia repair. A total of 233 (0.7%) of these had been given the diagnosis of male infertility after their first operation. We did not find any differences between expected and observed cumulative incidences of infertility in men operated with hernia repair. Men with bilateral hernia repair had a slightly increased risk for infertility when mesh was used on either side. However, the cumulative incidence was less than 1%.
Inguinal hernia repair with mesh is not associated with an increased incidence of, or clinically important risk for, male infertility.
先前的研究表明，在腹股沟疝修补术中使用网片可能会增加精索结构炎症性闭塞，从而导致男性不育的风险。在最近的一项研究中，我们并未发现男性不育的发生率增加。本研究旨在进一步探讨这一问题。
我们将 1950 年至 1989 年间出生、1992 年至 2007 年间在瑞典疝登记处登记的疝修补术患者，与瑞典全国患者登记处诊断为男性不育的同年龄组的所有男性进行交叉链接。分析了累积和预期的不育发生率。分别对单侧和双侧疝修补术的男性进行了多变量逻辑分析，调整了年龄和首次修复后经过的时间。
总共确定了 34267 名至少有一次腹股沟疝修补史的男性。在这些男性中，有 233 名（0.7%）在首次手术后被诊断为男性不育。我们未发现使用网片进行疝修补术的男性中，预期和观察到的不育累积发生率之间存在差异。使用双侧疝修补术且两侧均使用网片的男性，其不育风险略有增加。然而，累积发生率小于 1%。
腹股沟疝修补术中使用网片与男性不育的发生率增加或临床上重要的不育风险无关。
