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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study, the long-term effects of mesh and its localisation (i.e. anterior or posterior) on testicular perfusion and testicular function were evaluated in groin hernia patients. Testicular function has been evaluated with spermiogram and testicular perfusion with colour Doppler ultrasonography. Group I: consisted of 30 posterior preperitoneal mesh repair patients Group II: consisted of 30 anterior tension-free repair patients. The operation types were randomised with a systematic sampling method. There was no statistically significant difference between pre-operative and postoperative spermiogram results for both groups. No statistically significant difference was found between the two groups in terms of Doppler flow parameters (PSV, EDV, RI and PI) for pre-operative, early and late postoperative periods. When Doppler flow parameters were compared for group I, statistically significant differences were found between pre-operative and early postoperative values. No statistically significant difference was found between pre-operative and late postoperative values. This is also true for early postoperative values versus late postoperative values. When Doppler flow parameters were compared for group II, statistically significant differences were found between pre-operative and early postoperative values. No statistically difference was found between pre-operative and late postoperative values. This is also true for early postoperative values versus late postoperative values. These results support the idea that inguinal mesh application is still a safe procedure in patients with no children or who are undergoing infertility treatment, where testicular function is important.
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PMID:Effect of mesh and its localisation on testicular flow and spermatogenesis in patients with groin hernia. 1474 69

The authors present a case of hernia uteri inguinale, or the presence of Mullerian duct structures in an inguinal hernia. This entity presents in phenotypic males presumably secondary to defects in the action of the Mullerian inhibiting substance and presents a pediatric surgeon with management dilemmas. The long-term complications associated with the gonads if left intact include the risk of malignancy and infertility. We describe the use of the laparoscopic technique in the management of this condition and propose an algorithm for the management of this condition.
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PMID:Hernia uterus inguinale: a proposed algorithm using the laparoscopic approach. 1705 85

Polyorchidism is an urogenital curiosity defined by the presence of more than two testes confirmed by histology. This anomaly is extremely rare and only a hundred world cases were described in the literature. Although it can remain asymptomatic, polyorchidism is often associated to processus vaginalis anomalies in childhood (hernia, hydrocele) and undescended testis. The review of the literature finds cases of polyorchidism revealed by testis torsion and an increased risk of malignancy and infertility. We report the case of polyorchidism in a 14 year old child, at whom a painful testis mass indicate surgical exploration and documented the histological diagnosis of polyorchidism. Through this observation and review of the literature, authors describe pathological and managment findings of polyorchidism.
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PMID:[Polyorchidism in child (a case report and review of literature)]. 1763 6

Almost all groin hernias in children are indirect inguinal hernias and occur as a result of incomplete closure of the processus vaginalis. The treatment is repair by high ligation of the hernia sac, which can be done by an open or laparoscopic technique. The contralateral side can be explored by laparoscopy or left alone; open exploration is no longer indicated due to the potential risk of infertility. Umbilical hernias are common in infants but usually close with time. Surgery is indicated if the umbilical hernia is symptomatic or if the fascial defect fails to decrease in size over time.
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PMID:Pediatric hernias. 1826 60

Aim of this paper is to report a systematic review of the literature about the incidence and putative mechanisms of genital tract injuries following open and laparoscopic herniorraphy and their effects on sexual function and fertility and to point out the measures of prevention and of treatment. The most frequently described events have been intraoperative complications as bladder or spermatic cord structure damage, immediate postoperative complications as ischaemic orchitis, urinary retention, urinary tract infection, hydrocele or scrotal haematoma and bacterial orchitis, or long-term complications as chronic orchialgia, testis atrophy, sexual dysfunction and infertility. The evidence of literature shows that urological complication after hernioplasty are under-reported. Only a small number of studies to date have essentially dealt with sexual quality of life after inguinal hernia surgical repair. The sexual needs of patients with groin hernias are rarely discussed. Extensive laparoscopic procedures, due to the need of learning curve, have increased the risk of vas damage and infertility in young patients candidate to hernioplasty. Early diagnosis prevents urological complication as well as possible legal claims after hernia repair: it should be include careful history, objective and subjective symptoms and signs of uro-genital pathologies, lab data when necessary, immediate eco-color-Doppler imaging and urgent urological consultation. Despite the lack of prospective randomized trials, there is a growing evidence in literature about positive impact of hernioplasty on sexual function, encouraging future studies on this issue.
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PMID:Urological complications following inguinal hernioplasty. 2321 Apr

Kartagener's syndrome is a rare, autosomal recessive genetic ciliary disorder comprising the triad of situs inversus, chronic sinusitis, and bronchiectasis. The basic problem lies in the defective movement of cilia, leading to recurrent chest infections, ear/nose/throat symptoms, and infertility. We hereby report three unusual cases of this rare entity - an infertile male with azoospermia in whom Bochdalek's diaphragmatic hernia coexisted, another case of an infertile female, and a third of an infertile male with oligospermia. The need for a high index of suspicion to make an early diagnosis cannot be overemphasized in such patients so that wherever possible, options for timely treatment of infertility may be offered and unnecessary evaluation of symptoms is avoided.
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PMID:Kartagener's syndrome: A case series. 2324 52

Abdominal wall hernia correction is one of the most common surgical procedures. 85,000 hernia operations are performed in Poland each year. Modern techniques of abdominal wall reconstruction utilize surgical implants for fascial defect closure. In the 70s and the 80s of the last century, these techniques gained widespread acceptance among surgeons. Significant improvement of results in terms of recurrences was observed. Treatment of large abdominal wall defects became possible. Three types of surgical implants were developed early: polipropylene (PP), poliethylene (PE) and politetrafluoroethylene (PTFE). Unfortunately, negative effects of implanted material soon became apparent. Excessive native tissues inflammatory response to the implanted material, leading to multiple complications was observed. Recurrences due to fibrosis, chronic regional pain, stiffness of the operation site, intestinal adhesions and fistulas, infertility and infections were reported. In some cases the use of standard synthetic implant was contraindicated. Analyzing drawbacks of the standard hernia implants, the medical industry developed new materials to improve treatment results. The most popular, currently utilized synthetic materials, are presented in this review in the context of clinical results.
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PMID:Synthetic implants in hernia surgery. 2459 16

BACKGROUND The aim of our study was to determine an influence of incarcerated inguinal hernia mesh repair on testicular circulation and to investigate consequent sperm autoimmunity as a possible reason for infertility. MATERIAL AND METHODS This prospective study was performed over a 3-year period, and 50 male patients were included; 25 of these patients underwent elective open mesh hernia repair (Group I). Group II consisted of 25 patients who had surgery for incarcerated inguinal hernia. Doppler ultrasound evaluation of the testicular blood flow and blood samplings for antisperm antibodies (ASA) was performed in all patients before the surgery, on the second day, and 5 months after. Main outcome ultrasound measures were resistive index (RI) and pulsative index (PI), as their values are inversely proportional to testicular blood flow. RESULTS In Group I, RI, and PI temporarily increased after surgery and then returned to basal values in the late postoperative period. Friedman analysis showed a significant difference in RI and PI for all measurements in Group II (p<0.05), with a significant decrease between the preoperative, early, and late postoperative periods. All final values were within reference range, including ASA, despite significant increase of ASA in the late postoperative period. CONCLUSIONS Although statistically significant differences in values of testicular flow parameters and immunologic sensitization in observed time, final values remained within the reference ranges in all patients. Our results suggest that the polypropylene mesh probably does not cause any clinically significant effect on testicular flow and immunologic response in both groups of patients.
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PMID:Incarcerated Inguinal Hernia Mesh Repair: Effect on Testicular Blood Flow and Sperm Autoimmunity. 2714 57

Objective: To evaluate the efficacy and safety of microsurgical crossover vasovasostomy in treating complicated obstructive azoospermia. Methods: The data of 14 patients with complicated obstructive azoospermia treated with microsurgical crossover vasovasostomy were reviewed from October 2012 to March 2016.Ten of them underwent microsurgical crossover vasovasostomy. Intraoperative exploration revealed that 2 patients had vas deferens injury and contralateral testicular atrophy or epididymal obstruction due to previous hernia repair; 7 patients had obstruction of intracorporeal vas deferens on one side and epididymal obstruction on the other side; the other 1 patient had unilateral vasal obstruction with contralateral epididymal obstruction. Furthermore, 4 patients underwent microsurgical crossover vasoepididymostomy, including 3 patients who had obstruction at caput epididymis on one side, and obstruction at cauda epididymis and distal vas deferens on the other side; the other patient had absence of vas deferens in the scrotum on one side, and testicular atrophy on the other side. Regular follow-up visits were conducted after the surgery. Results: Two patients were lost to follow-up; the other 12 patients were follow-up for an average of 11 (range: 2-23) months. In the 10 cases receiving microsurgical crossover vasovasostomy (including 2 patients lost to follow-up), 1 has not undergone semen re-analysis, 6 were confirmed patent, including 3 reporting spontaneous pregnancy. The patency rate in the 4 patients receiving microsurgical crosseover vasoepididymostomy was 2/4, with 1 patient reporting spontaneous pregnancy. There was no complaint of discomfort or complications following the surgery. Conclusions: Microsurgical crossover anastomosis may be effective and safe for patients with complicated obstructive azoospermia, according to preoperative assessment and intraoperative exploration. It allows natural conception for patients with refractory infertility. The microsurgical crossover anastomosis could be an effective therapy to achieve satisfactory patency of vas deferens.
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PMID:[Effectiveness of microsurgical crossover anastomosis in treating complicated obstructive azoospermia]. 2776 Jun 28

Indirect inguinal hernia is one of the most common congenital anomalies in children, with a reported prevalence of 0.8-4.4%.1 About 15-20% of hernias in female infants contain ovary, and in rare cases a fallopian tube.2 However, only a few cases contain the uterus and both ovaries in the hernia sac.3 The normal anatomy is altered when an ovary is trapped in a hernia sac, and these changes make torsion more likely and increase the risk of infertility. Although an irreducible ovary is not at great risk of compression of its blood supply, in these occurrences, ovarian torsions have been reported in 2%-33%, emphasizing the importance of early surgical repair in irreducible hernias, even in asymptomatic patients.4 The presentation of an asymptomatic palpable movable mass over the labium major always suggests sliding hernia with ovary. To our knowledge, only a few reports of hernia sac containing uterus, fallopian tube, and ovary in a female patient have appeared in the literature. We suggest that sonography be performed routinely in female infants with an inguinal hernia containing a palpable movable mass. We present a rare case of premature female infant with a labial mass containing the uterus, both ovaries, and fallopian tubes.
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PMID:Irreducible Indirect Inguinal Hernia in Premature Infant with Ectopic Uterus and Bilateral Adnexa. 2804 87


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