Calisir Akin, Ece Ilhan, Yilmaz Huseyin, Alptekin Husnu, Colak Bayram, Yormaz Serdar, Gul Murat, Sahin Mustafa
Department of Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey.
Department of Urology, Faculty of Medicine, Selcuk University, Konya, Turkey.
Andrologia. 2021 Mar;53(2):e13947. doi: 10.1111/and.13947. Epub 2020 Dec 23.
Pain during sexual activity and ejaculation are the unspoken long-term complications of groin hernia repair. Laparoscopic surgical techniques are associated with decreased post-operative pain and earlier return to daily activities, but its effect on these complications is unclear. This study aims to investigate the effect of transabdominal preperitoneal repair (TAPP) on de-novo pain during sexual intercourse and ejaculation and to compare with open repair. For this reason, two groups were determined according to the surgical technique: the Lichtenstein repair and the TAPP groups and a questionnaire was sent to the patients a minimum of 6 months following the surgery. A total of 317 patients included, as 115 in TAPP and 202 in Lichtenstein repair group. No significant difference was observed concerning pre-operative pain during sexual activity and ejaculation in both groups (p = .75, p = .56). Following the surgery, the number of patients experiencing painful sexual activity was significantly higher in the Lichtenstein repair group compared to the TAPP group (19.3% vs. 11.3%, respectively, p = .03). The post-operative painful ejaculation rate was also significantly lower for the TAPP group (p = .04). The lower rates of post-operative dysejaculation and pain during sexual activity can be achieved with the advantage of laparoscopic surgery.
性活动和射精时的疼痛是腹股沟疝修补术潜在的长期并发症。腹腔镜手术技术与术后疼痛减轻及更早恢复日常活动相关,但它对这些并发症的影响尚不清楚。本研究旨在探讨经腹腹膜前修补术(TAPP)对性交和射精时新发疼痛的影响,并与开放修补术进行比较。因此,根据手术技术将患者分为两组:Lichtenstein修补术组和TAPP组,并在术后至少6个月向患者发送问卷。共纳入317例患者,其中TAPP组115例,Lichtenstein修补术组202例。两组患者术前性活动和射精时的疼痛情况无显著差异(p = 0.75,p = 0.56)。术后,Lichtenstein修补术组经历性交疼痛的患者数量显著高于TAPP组(分别为19.3%和11.3%,p = 0.03)。TAPP组术后射精疼痛率也显著较低(p = 0.04)。腹腔镜手术的优势在于可降低术后射精障碍和性活动时疼痛的发生率。