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Does mesh implantation affect the spermatic cord structures after inguinal hernia surgery? An experimental study in rats

Berndsen, FH; Bjursten, Lars Magnus LU ; Simanaitis, M and Montgomery, Agneta LU (2004) In European Surgical Research 36(5). p.318-322
Abstract
Background: Inguinal hernia repair is the most common operation in general surgery. Prosthetic reinforcement of the inguinal area with polypropylene mesh has increased dramatically in the last decade. The aim of this study was to evaluate how different types of mesh affect the spermatic cord structures. Methods: Thirty rats were divided into three groups. The spermatic cord was dissected free and a conventional suture repair was performed in group I, an operation mimicking the Lichtenstein operation with a heavyweight polypropylene mesh in group II and the same operation using large pore, lightweighted polypropylene/polyglactin composite mesh in group III. A vasography was performed after 90 days. The cross-sectional area of the vas... (More)
Background: Inguinal hernia repair is the most common operation in general surgery. Prosthetic reinforcement of the inguinal area with polypropylene mesh has increased dramatically in the last decade. The aim of this study was to evaluate how different types of mesh affect the spermatic cord structures. Methods: Thirty rats were divided into three groups. The spermatic cord was dissected free and a conventional suture repair was performed in group I, an operation mimicking the Lichtenstein operation with a heavyweight polypropylene mesh in group II and the same operation using large pore, lightweighted polypropylene/polyglactin composite mesh in group III. A vasography was performed after 90 days. The cross-sectional area of the vas deferens and s-testosterone from the spermatic vein were measured using the contralateral side as control. Light microscopy of the inguinal canal was performed and inflammation and fibrosis were graded. Results: Vasography revealed patent vas deferens in all animals. In group III, there was a lower s-testosterone in the spermatic vein and a reduced cross-sectional area of the vas deferens on the operated compared to the control side. However, there was no difference in the other groups and there was no significant difference in s-testosterone levels between the groups. There was significantly more inflammation and fibrosis after mesh repair compared to suture repair, but there was no difference between the two mesh groups. Unexpectedly, polyglactin fibres were still seen in specimens in group III after 90 days. Conclusion: In conclusion, the only effect on the spermatic cord structures in a rat model is seen as an impaired s-testosterone production and a reduced cross-sectional area of the vas deferens after use of a low-weight composite mesh compared to the control side. No difference in inflammation or fibrosis was found between heavyweight polypropylene mesh and low-weight composite mesh. Copyright (C) 2004 S. Karger AG, Basel. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
mesh repair, inguinal hernia repair, foreign body reaction, mesh, experimental study, polypropylene mesh, implantation
in
European Surgical Research
volume
36
issue
5
pages
318 - 322
publisher
Karger
external identifiers
  • wos:000224988700009
  • scopus:4644238045
ISSN
0014-312X
DOI
10.1159/000079918
language
English
LU publication?
yes
id
034d0885-323e-4b98-b3c6-70a130bfa26a (old id 897994)
date added to LUP
2008-01-10 11:32:40
date last changed
2017-02-12 03:36:38
@article{034d0885-323e-4b98-b3c6-70a130bfa26a,
  abstract     = {Background: Inguinal hernia repair is the most common operation in general surgery. Prosthetic reinforcement of the inguinal area with polypropylene mesh has increased dramatically in the last decade. The aim of this study was to evaluate how different types of mesh affect the spermatic cord structures. Methods: Thirty rats were divided into three groups. The spermatic cord was dissected free and a conventional suture repair was performed in group I, an operation mimicking the Lichtenstein operation with a heavyweight polypropylene mesh in group II and the same operation using large pore, lightweighted polypropylene/polyglactin composite mesh in group III. A vasography was performed after 90 days. The cross-sectional area of the vas deferens and s-testosterone from the spermatic vein were measured using the contralateral side as control. Light microscopy of the inguinal canal was performed and inflammation and fibrosis were graded. Results: Vasography revealed patent vas deferens in all animals. In group III, there was a lower s-testosterone in the spermatic vein and a reduced cross-sectional area of the vas deferens on the operated compared to the control side. However, there was no difference in the other groups and there was no significant difference in s-testosterone levels between the groups. There was significantly more inflammation and fibrosis after mesh repair compared to suture repair, but there was no difference between the two mesh groups. Unexpectedly, polyglactin fibres were still seen in specimens in group III after 90 days. Conclusion: In conclusion, the only effect on the spermatic cord structures in a rat model is seen as an impaired s-testosterone production and a reduced cross-sectional area of the vas deferens after use of a low-weight composite mesh compared to the control side. No difference in inflammation or fibrosis was found between heavyweight polypropylene mesh and low-weight composite mesh. Copyright (C) 2004 S. Karger AG, Basel.},
  author       = {Berndsen, FH and Bjursten, Lars Magnus and Simanaitis, M and Montgomery, Agneta},
  issn         = {0014-312X},
  keyword      = {mesh repair,inguinal hernia repair,foreign body reaction,mesh,experimental study,polypropylene mesh,implantation},
  language     = {eng},
  number       = {5},
  pages        = {318--322},
  publisher    = {Karger},
  series       = {European Surgical Research},
  title        = {Does mesh implantation affect the spermatic cord structures after inguinal hernia surgery? An experimental study in rats},
  url          = {http://dx.doi.org/10.1159/000079918},
  volume       = {36},
  year         = {2004},
}