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腹股沟疝网片修补术对睾丸血流和精子自身免疫的影响。

Influence of inguinal hernia mesh repair on testicular flow and sperm autoimmunity.

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital Split, Split University School of Medicine, Split, Croatia.

出版信息

Hernia. 2012 Aug;16(4):417-24. doi: 10.1007/s10029-012-0918-1. Epub 2012 May 10.

Abstract

BACKGROUND

The incidence of infertility caused by the mesh inguinal hernia repair is not known. The aim of this study was to determine circulation and immunological testicular disorders after inguinal hernia mesh repair which can be related with infertility.

METHODS

From February 2010 to December 2010, 43 male patients who underwent inguinal hernia mesh repair were included in a prospective study. Testicular, capsular and intratesticular arterial flow dynamics were measured by Color Doppler ultrasound before the operation, in early and late postoperative period. The antisperm antibodies were analyzed before hernia repair and 5 months after.

RESULTS

The difference between patients who underwent laparoscopic (Group I) and anterior open tension-free hernia repair (Group II) in age, duration of symptoms and hernia characteristics were not significant. Statistically significant differences were found in peak-systolic and end-diastolic velocity in testicular and intratesticular arteries in Group II and in peak-systolic velocity on all levels in Group I. Only Group I had significant differences in resistive index of intratesticular arteries. All the values returned to basal in late postoperative period except testicular peak-systolic velocity in Group I which stayed in normal range. Wilcox matched pair test showed significant difference between preoperative and late postoperative measurements of the antisperm antibodies only in Group II, but it was within normal range in all cases.

CONCLUSIONS

Inguinal hernia mesh repair do not have clinically significant influence on testicular flow and immunological response.

摘要

背景

网片修补腹股沟疝导致不孕的发生率尚不清楚。本研究的目的是确定腹股沟疝网片修补术后是否存在与不孕相关的睾丸循环和免疫障碍。

方法

2010 年 2 月至 2010 年 12 月,前瞻性研究纳入 43 例男性腹股沟疝网片修补术患者。术前、术后早期和晚期应用彩色多普勒超声测量睾丸、囊和睾丸内动脉血流动力学。在疝修补术前和术后 5 个月分析抗精子抗体。

结果

腹腔镜组(I 组)和开放式无张力疝修补组(II 组)在年龄、症状持续时间和疝特征方面无显著差异。II 组睾丸和睾丸内动脉收缩期峰值和舒张末期速度有统计学显著差异,I 组所有水平的收缩期峰值速度也有统计学显著差异。只有 I 组睾丸内动脉阻力指数有显著差异。除 I 组睾丸收缩期峰值速度仍在正常范围内外,所有值在术后晚期均恢复至基础值。Wilcox 配对检验仅显示 II 组抗精子抗体术前和术后晚期测量值有显著差异,但均在正常范围内。

结论

腹股沟疝网片修补术对睾丸血流和免疫反应无明显临床影响。

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