scholarly journals Factors that predict testicular atrophy in patients who underwent inguinal hernia repair

2020 ◽  
Vol 7 (11) ◽  
pp. 3550
Author(s):  
Faraj Afandiyev ◽  
Haydar Celasin ◽  
Serdar Culcu

Background: Some of the patients that undergo inguinal hernia repair develop testicular atrophy. Testicular atrophy development also brings about a lot of problems. In our study, we aimed to determine the rate of development of testicular atrophy and predicting factors in patients that undergo inguinal hernia repair in our hospital.Methods: Patients who underwent inguinal hernia repair in our centre from January 2017 to January 2020 were included in our study. Total number of patients was 158 divided into 2 groups i.e. group-1 (those who developed testicular atrophy after inguinal hernia repair) and group-2 (those who did not develop testicular atrophy after inguinal hernia repair). We investigated the relationship between the development of testicular atrophy and age, hernia type and localization, duration of surgery and anesthesia, perioperative non-steroidal anti-inflammatory drugs (NSAID) and antispasmolytic use, diabetes mellitus and rheumatological disease and, perioperative fluid replacement.Results: Testicular atrophy developed in 6 of the patients (3.79%). We found that testicular atrophy was mostly secondary and mostly visible in cases underwent open repair (p=0.0001); and in which left and bilateral inguinal hernia repair was performed (p=0.014); and in cases with DM and rheumatological diseases (p=0.0001). We also found that the use of perioperative antispasmolytic and NSAID was lower in patients with testicular atrophy (p=0.0001).Conclusions: According to the results of our study, advanced age, secondary and open repair, diabetes mellitus, rheumatological disease history, not using antispasmolytic and NSAID increases the risk of testicular atrophy.

2020 ◽  
Vol 11 (6) ◽  
pp. 84-88
Author(s):  
Atia Zaka Ur Rab ◽  
Sheikh Saif Alim ◽  
Wasif Mohammad Ali ◽  
Syed Amjad Ali Rizvi

Background: Inguinal hernia surgery is one of the most common elective procedures performed by the surgeons and has evolved from open to the laparoscopic technique. Aims and Objectives: This prospective study was conducted to find out intra-operative and post-operative outcomes in patients undergoing TEP and TAPP for inguinal hernia repair. Materials and Methods: A prospective study was conducted on 50 adult patients who underwent laparoscopic inguinal hernia repair between November 2017 to November 2018. It was a randomized study and equal number of patients were allocated to TAPP and TEP group based on the surgeon’s preference. Results: Operative time [p<0.0001], intensity of pain (VAS) was significantly higher in TAPP compared to TEP in the immediate post-operative period (6 hours) and during hospital stay [p=0.0299]. No significant difference observed in VAS between TEP and TAPP during follow up [after 1 week (p=0.2298), 2 weeks (p=0.2337), and 4 weeks (p=0.3944)]. Both TEP and TAPP were comparable in terms of Intra-operative and Post-operative complications {seroma [during hospital stay (p=0.1573), after 1 week (p=0.6375), after 2 weeks (p=0.5513)]; haematoma [during hospital stay (p=0.1492), after 1 week (p=0.3125)]} and Conversion (p=0.3125), and Length of hospital stay (p=0.3960). Time to resume normal work [p<0.0001] was significantly more in TAPP than TEP. Conclusion: TEP has a definite edge over TAPP taking into consideration the lesser intensity of post-operative pain during hospital stay, shorter duration of surgery and relatively early return to normal work associated with the former procedure. TEP should therefore be regarded as the procedure of choice for inguinal hernia repair.


2020 ◽  
Vol 7 (11) ◽  
pp. 3735
Author(s):  
Haydar Celasin ◽  
Faraj Afandiyev ◽  
Serdar Culcu

Background: Some of the patients that undergo inguinal hernia repair develop urinary retention. We aimed to determine the rate of development of urinary retention and predicting factors after inguinal hernia repair.Methods: Patients who underwent inguinal hernia in our center from January 2017 to January 2020 were included in the study. Patients were examined in 2 groups; group1 (developed urinary retention after inguinal hernia repair) and group 2 (did not develop urinary retention after inguinal hernia repair). We investigated the relationship between the development of urinary retention with age, perioperative history of benign prostate obtruction, hernia type and localization, duration of surgery and anesthesia, perioperative non-steroidal anti-inflammatory drug (NSAID), narcotic analgesic and antispasmolytic use, having diabetus mellitus (DM) and rheumatoid diseases, and perioperative fluid replacement.Results: in group 1 and group 2, urinary retention developed in 11 (7.6%) of the patients. Patients who developed post-urinary retention were older than those without urinary retention (p=0.007). The BPO, DM rates were higher (p=0.0001), anesthesia and operation times were longer (p=0.003; p=0.0001); perioperative antispasmolytic use was higher (p=0.0001); we determined that postoperative fluid replacement rate was higher (p=0.003) and the rate of preoperative NSAID use was lower (p=0.0001). Clavien grade 4 and grade 5 complications were not observed in patients.Conclusions: Elderliness, DM history, antispasmolytic use, long operation and anesthesia duration, excessive postoperative fluid replacement and, not using perioperative NSAID increases the risk of urinary retention.


2021 ◽  
pp. 51-53
Author(s):  
Sanjay Kumar ◽  
Kumar Vikram ◽  
Manoj Kumar ◽  
Debarshi Jana

Background: Lower urinary tract symptoms (LUTS) are frequently associated with inguinal hernias. It is important to recognise and treat bladder outlet obstruction in patients before inguinal hernia repair to prevent recurrence of hernia. Methods: This prospective study was conducted at Department of Surgery, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. Hundred patients who presented with inguinal hernia repair were evaluated for LUTS using AUA scoring for urinary symptoms, uroowmetry (Qmax) and post voidal residual urine using ultrasonography along with urine routine microscopic examination and urine culture and sensitivity. Results: Eleven patients out of 100 who came for hernia repair had clinically signicant LUTS due to benign enlargement of prostate (BEP) and required treatment for BEP but none of these 11 patients had urinary symptoms as primary complaint. Ten patients were found to have urinary tract infection without any urinary symptom. Three patients had urethral stricture out of which 2 had Qmax of <10 ml/second. Conclusions: Signicant number of patients (14 percent) with inguinal hernia had lower urinary tract symptoms. An effort should be made to identify LUTS in patients presenting with inguinal hernia before surgery and treat the cause of LUTS. Ten percent of patients had asymptomatic UTI with AUA score less than 8 but Qmax on uroowmetry was in between 10-15 ml/second.


2017 ◽  
Vol 83 (12) ◽  
pp. 1418-1421 ◽  
Author(s):  
David S. Edelman

Laparoscopic inguinal hernia repair has certain advantages over open repair including less pain and earlier return to normal activity. Concurrent robotic inguinal hernia repair at the time of prostatectomy has been shown to have a lower recurrence rate than open repair. Robotic surgery adds high definition visualization and articulating instruments which enhances dexterity that makes laparoscopic hernia repair more refined. A series of robotic, laparoscopic, inguinal hernia repairs by a single surgeon with an extensive laparoscopic hernia experience at a single institution was undertaken to determine the role of robotic laparoscopic inguinal hernia repair in minimally invasive surgery. Five hundred forty-two laparoscopic inguinal hernia operations were performed from April 2012 through December 2015. There were 154 cases of robotic transabdominal pre-peritoneal procedures done during that time. Hospital records and follow-up care were pro-spectively reviewed and data collected for age, sex, American Society of Anesthesia class, and operative time. Follow-up was done at 2, 8, and 16 weeks after surgery. All patients consented for the study. Ninety percent of the patients were male. Age averaged 57.04 years with a range of 21 to 85 years. American Society of Anesthesia averaged 2.01 with comorbidities of hypertension, hypercholesterolemia, and gastroesophageal reflux disease being the most common. Body mass index was between 19 and 31.6, averaging 24.34. Twenty-five patients (16%) had an umbilical hernia repair done concomitantly. Operating room time ranged from 25 to 140 minutes with an average of 63.6 minutes decreased as experience increased. One patient with a large, left scrotal hernia was converted to open; one patient developed perforated sigmoid diverticulitis seven days postop and case #5 recurred indirectly after a direct hernia repair. Four patients required prolonged postoperative Foley catheterization. Robotic inguinal hernia repair is safe and effective. Operating room time was longer than standard laparoscopic herniorrhaphy but decreased with experience. A single-port platform may have use in patients with umbilical hernias, 16 per cent, and will need to be studied.


2018 ◽  
Vol 5 (11) ◽  
pp. 3719
Author(s):  
Komal B. Gurung ◽  
Niroj Banepali ◽  
Rakesh R. Sthapit ◽  
Baikuntha Adhikari

Background: Laparoscopic inguinal hernia repair has been proven to be a safe and effective procedure for groin hernias. In recent years, many of the tertiary centers in Nepal have started performing laparoscopic hernia repair. With the availability of resources and the facilities, the laparoscopic repairs for inguinal hernias are going to be more accessible in near future in Nepal. The aim of this study was to compare the intraoperative events and postoperative complications of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques of laparoscopic inguinal hernia repairs.Methods: Out of 56 patients, 30 underwent TAPP and 26 TEP repairs for primary unilateral inguinal hernias and were prospectively analyzed. Patient demographics, past medical and surgical history, intraoperative, and postoperative events were recorded. Patients were followed-up for two years.Results: Demographic parameters were comparable in both the groups. The difference in mean operating time was statistically significant (longer in the TAPP group). Intraoperative events such as port-site bleeding and peritoneal tear were comparable in both groups. The immediate postoperative complications like skin ecchymosis, cord hematoma, and scrotal edema were comparable in both repairs.  Immediate postoperative pain was significantly lesser in TEP repair whereas the hospital stays and time to return to the normal physical activity were comparable in both groups.Conclusions: Both TAPP and TEP laparoscopic techniques are safe and effective for inguinal hernia repair. However, there are few advantages of TEP repair such as shorter duration of surgery and less postoperative pain.


2011 ◽  
Vol 27 (2) ◽  
pp. 86 ◽  
Author(s):  
Adnan Haslak ◽  
Ibrahim Taskin Rakici ◽  
Beyza Ozcinar ◽  
Ali Tardu ◽  
Yavuz Selim Sari ◽  
...  

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Barghash ◽  
T ElGhobashy ◽  
N Cheema ◽  
M Mansour

Abstract Aim Inguinal hernia repairs are one of the most commonly performed operative procedures in the UK. An adequate consent process gives the patient the autonomy in making decisions related to their care and treatment. In this project, we were auditing whether hernia patients have gone through a standardised consent process from time clinic presentation up to the day of surgery. Method This was a retrospective audit based on the Royal College of Surgeons’ (Good Surgical Practice) guidelines and trust local policy. We assessed 50 case notes for patients who had inguinal hernia repair between November 2019 and November 2020 in two of the busy district general hospitals in the UK. Results We found that our practice was fully compliant with documenting patient demographics, signatures, and the name of the procedure in the consent forms. Documented discussion prior to surgery was found only on79% of clinic letters. Poor compliance was noted in documenting some of the possible risks in the consent form including testicular atrophy (59%), injury to vas, vessels, and nerves (56%), wound complications (49%), chest infection (24%). Zero compliance was noted in documentation missed hernia and mortality as potential risks to the procedure. Conclusions A detailed documented discussion with the patient in relation to benefits, risks, and alternatives of surgery should take place on clinic presentation as well as on the day of surgery to ensure compliance with the consent process.


2019 ◽  
Vol 6 (10) ◽  
pp. 3576
Author(s):  
Sudhir Kumar Jain ◽  
Tariq Hameed ◽  
Shankar Sundarraj ◽  
Faiz Manzar Ansari

Background: Lower urinary tract symptoms (LUTS) are frequently associated with inguinal hernias. It is important to recognise and treat bladder outlet obstruction in patients before inguinal hernia repair to prevent recurrence of hernia.Methods: This prospective study was conducted at Maulana Azad Medical College. Hundred patients who presented with inguinal hernia repair were evaluated for LUTS using AUA scoring for urinary symptoms, uroflowmetry (Qmax) and post voidal residual urine using ultrasonography along with urine routine microscopic examination and urine culture and sensitivity.Results: Eleven patients out of 100 who came for hernia repair had clinically significant LUTS due to benign enlargement of prostate (BEP) and required treatment for BEP but none of these 11 patients had urinary symptoms as primary complaint. Ten patients were found to have urinary tract infection without any urinary symptom. Three patients had urethral stricture out of which 2 had Qmax of <10 ml/second.Conclusions: Significant number of patients (14 percent) with inguinal hernia had lower urinary tract symptoms. An effort should be made to identify LUTS in patients presenting with inguinal hernia before surgery and treat the cause of LUTS. Ten percent of patients had asymptomatic UTI with AUA score less than 8 but Qmax on uroflowmetry was in between 10-15 ml/second.


2020 ◽  
Vol 3 (1) ◽  
pp. 149-154
Author(s):  
Mohd. Ilyas ◽  
Venkat Vaijnath Cholleti

Background: Hernia is one of the common surgical problems. Repair of inguinal hernia is one of the commonest surgical procedures worldwide, irrespective of country, race or socio-economic status and constitutes a major health-care in every country. Subjects and Methods: This is a randomised prospective study done over 50 patients in the department of general surgery of Kamineni hospitals, LB Nagar, Hyderabad during the period of October 2010 to August 2012 with the aim to compare laproscopic inguinal hernia repair and open inguinal hernia repair with regards to post-operative pain, surgical site infections, hospital stay and time taken to return to work, by a randomized study. Results: Compare laparoscopic and mesh inguinal hernia repairs, there is no significant difference in early assessment with regards to duration of operation, post-operative pain, analgesic requirements on the day of surgery and first post-operative day, hospital stay, return to daily and normal activities and post-operative complications. Conclusion: Laparoscopic mesh hernioplasty still remains to be validated with larger number of patients and longer duration of follow up.


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