scholarly journals Is inguinal hernia repair safe for testicular atrophy? Our 10 year results

2021 ◽  
Vol 8 (2) ◽  
pp. 606
Author(s):  
Haydar Celasin ◽  
Faraj Afandiyev
Keyword(s):  
Inguinal Hernia ◽  
Rheumatic Disease ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Testicular Atrophy ◽  
Inflammatory Drugs ◽  
Group 2 ◽  
Group 1

Background: We aimed to determine the incidence and predictors of testicular atrophy (TA) in patients undergoing inguinal hernia repair at our hospital.Methods: The total patient number is 578.The patients were divided Group-1 (developed testicular atrophy) and Group-2 (did not develop testicular atrophy). The testicles were evaluated with Scrotal Color Doppler Ultrasonography (SCDU) in preoperative and postoperative third month.Results: Median age in the Group - 1 and Group - 2 respectively is 64,0±12,3 (47-81) and 48,9±17,4 (18-89) (p=0.037). TA developed in 5.01% (29/578) of the patients. We determined that TA developed more often in the patients who are over the age of 40 (p=0.007), in secondary cases (p<0.001), in  open repair (p<0.001), those who do not use perioperative narcotic and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) (p<0.001), those who use perioperative antispasmodic drugs (p=0.017), those having a rheumatic disease(RD) and  diabetes mellitus(DM) (p<0.001).Results of multivariate analysis, testicular atrophy development increases when perioperative NSAID is not used ( OR:13.24; 95% CI:4.19-41.87; p<0.001) , perioperative narcotic is not applied (OR:13.91; 95% CI:4.35-44.55; p<0.001) and RD exists (OR:0.10; 95%CI:0.03-0.35; p<0.001).Conclusions: Advanced age, DM and rheumatic disease, not using perioperative NSAIDs, narcotic drugs and antispasmodic drugs increases the risk of testicular atrophy.

Bupivacaine Hydrochloride and Ketamine Hydrochloride with Dextrose Given Intrathecally for Inguinal Hernia Repair - A Randomized Controlled Study in a Tertiary Centre in South Kerala

2021 ◽  
Vol 8 (31) ◽  
pp. 2830-2834
Author(s):  
Ranju Sebastian ◽  
Remani Kelan Kamalakshi ◽  
Jamsheena Muthira Parambath ◽  
Praseetha Vallomparambath Kuttiparambil
Keyword(s):  
Inguinal Hernia ◽  
Side Effects ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Spinal Anaesthesia ◽  
Controlled Study ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
Group 2 ◽  
Group 1

BACKGROUND Spinal Anaesthesia is the most commonly used form of anaesthesia for surgeries below the level of umbilicus. Bupivacaine is the drug of choice for subarachnoid block. Spinal anaesthesia with bupivacaine is associated with many side effects and complications especially in patients with multiple co-morbid conditions. In our study we compared the anaesthetic effectiveness of 3.5 ml hyperbaric bupivacaine with a mixture of 100 mg ketamine and 0.1 mg adrenaline, the solution is made hyperbaric by adding 1.4 ml of 5 % dextrose given intrathecally. The objective of our study was to compare the anaesthetic properties and clinical effectiveness of intrathecally administered ketamine with bupivacaine for inguinal hernia repair. METHODS This randomised control study was conducted on fifty American society of Anaesthesiologists (ASA) 1 and 2 patients in the age group of 25 – 60 years posted for elective inguinal hernia repair from December 2004 to December 2005. They were randomized in to two groups. Group 1 (Bupivacine group) and Group 2 (Ketamine group). Bupivacaine group (group 1) received 3.5 ml of bupivacaine heavy and ketamine group (group 2) received preservative free ketamine 100 mg with 0.1 mg adrenalin 1/1000 solution in 1.4 ml of 5 % dextrose to make it heavy. Anaesthetic properties, side effects and complications of both groups were compared intraoperatively. RESULTS The onset of action of ketamine (1.58 minutes) was faster than bupivacaine (3.31 minutes) which is statistically significant. Duration of blockade was longer in bupivacaine group (sensory 227.92 and motor 203.08) compared to ketamine group (sensory 143.40 and motor 109.46). Ketamine group showed a greater level of haemodynamic stability than bupivacaine group. CONCLUSIONS Intrathecal ketamine produces optimal anaesthetic conditions for surgeries like inguinal hernia repair. Haemodynamic stability provided by intrathecal ketamine is beneficial in patients with multiple comorbidities. KEYWORDS Hyperbaric Bupivacaine, Ketamine in Hyperbaric Solution, Intrathecal Block, Inguinal Hernia Repair

scholarly journals Prophylaxis and treatment of acute and chronic postoperative inguinal pain (CPIP)—association of pain with compression neuropathy†

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
René Gordon Holzheimer ◽  
Nikolai Gaschütz
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Recurrence Rate ◽  
Nerve Damage ◽  
Preoperative Pain ◽  
Compression Neuropathy ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Abstract Can open inguinal hernia repair (OIHR) and tailored neurectomy (TN) be effective for prophylaxis of chronic postoperative inguinal hernia repair (CPIP) (I) and treatment of CPIP (II)? Patients with symptomatic primary inguinal hernia (I group 1) and secondary hernia with CPIP (II, groups 2–5) were investigated for postoperative complications and nerve damage. About, 98% of patients with OIHR with TN reported preoperative pain (I group 1, n = 388, recurrence rate 1%). There were 73 cases (II) of CPIP after laparoscopic inguinal hernia repair (LIHR) (group 2, n = 22), OIHR (group 3, n = 37), LIHR followed by OIHR/LIHR (group 4, n = 5) and OIHR followed by LIHR/OIHR (group 5, n = 9). The results were as follows: preoperative pain: 33–100%, recurrence rate 0–11% (II, groups 2–5), nerve damage 92–100% and persistent CPIP: n = 1 after trocar perforation of inguinal nerve elsewhere. OIHR is effective to avoid CPIP with compression neuropathy. This is the largest series of histological nerve damage in CPIP.

scholarly journals Totally extraperitoneal inguinal hernia repair versus Lichtenstein repair: a one-year follow-up study

2021 ◽  
Author(s):  
H. O. Havrylov ◽  
O. V. Shulyarenko
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Lightweight Mesh ◽  
Lichtenstein Repair ◽  
Totally Extraperitoneal ◽  
Totally Extraperitoneal Hernia Repair ◽  
Group 2 ◽  
One Year ◽  
Group 1

The inguinal hernia has an incidence of 27 — 43 % in males. Surgical repair is the most accepted treatment to prevent the development of complications. Laparoscopic inguinal hernia repair has become popular worldwide and includes the use of a laparoscopic technique for mesh placement behind the defect. Objective — to assess whether totally extraperitoneal (TEP) inguinal hernia repair shows benefits over Lichtenstein repair in intraoperative and one‑year follow‑up postoperative outcomes for male patients with primary unilateral inguinal hernia. Materials and methods. 53 males were randomly allocated to two groups. Group 1 included 27 patients who underwent totally extraperitoneal hernia repair using self‑gripping lightweight mesh, and group 2 included 26 patients who were treated surgically with Lichtenstein repair using lightweight mesh. Results. Both groups were comparable in mean age, type of hernia, body mass index and patient’s distribution according to the European hernia society classification. TEP repair takes on average a little less time as compared to Lichtenstein repair, and this difference is not statistically significant. The mean of visual analogue scale for pain scoring in the first 24 hours after surgery as well as in the next 24 hours is statistically significantly smaller in group 1 compared to group 2. The mean time taken to return to work was 2.15 times longer in group 2 than in group 1, and the difference was statistically significant. Conclusions. Totally extraperitoneal hernia repair shows potential benefits over Lichtenstein repair for primary unilateral inguinal hernias as it causes less pain in the postoperative period and ensures early return to work.  

scholarly journals Contribution of pre-varicocelectomy color Doppler ultrasonography finding to surgery and its correlation with semen parameters

2021 ◽  
Vol 93 (2) ◽  
pp. 227-232
Author(s):  
Caner Ediz ◽  
Muhammed Cihan Temel ◽  
Suna Şahin Ediz ◽  
Serkan Akan ◽  
Serkan Yenigürbüz ◽  
...  
Keyword(s):  
Physical Examination ◽  
Doppler Ultrasonography ◽  
Semen Analysis ◽  
Color Doppler ◽  
Color Doppler Ultrasonography ◽  
Semen Parameters ◽  
Significant Difference ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.

Effects of inguinal hernia repair techniques on testicular atrophy and sexual functions in the long-term

2011 ◽  
Vol 27 (2) ◽  
pp. 86 ◽  
Author(s):  
Adnan Haslak ◽  
Ibrahim Taskin Rakici ◽  
Beyza Ozcinar ◽  
Ali Tardu ◽  
Yavuz Selim Sari ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Testicular Atrophy ◽  
Repair Techniques

Inguinal Hernia Repair in a Neonate

2019 ◽  
pp. 294-311
Author(s):  
Andrew D. Franklin ◽  
J. Matthew Kynes
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Local Anesthetic ◽  
Transversus Abdominis ◽  
Opioid Analgesia ◽  
Anesthetic Techniques ◽  
Inflammatory Drugs ◽  
Regional Anesthetic ◽  
Neonatal Population

This chapter describes inguinal hernia repair in the neonatal infant, which is one of the most commonly performed pediatric surgeries on an ambulatory basis. However, as many patients were born prematurely, a variety of analgesic concerns exist such as comorbid chronic lung disease or the concurrent risk of postoperative apnea depending on age at presentation. Additionally as acute pain in the neonatal population is often underappreciated and may have a lasting impact, numerous analgesic modalities should be considered. Intraoperatively, while general anesthesia is an option, numerous regional anesthetic techniques are available that may minimize the use of sedating agents. Both neuraxial (epidural, spinal, caudal injection) and peripheral (ilioinguinal/iliohypogastric blockade, paravertebral blockade, or transversus abdominis plane blockade) are available as analgesic modalities and in some scenarios surgical modalities. With the use of any of these modalities, complications such as nerve damage, failed block, and local anesthetic toxicity may occur. Following surgery, some neonates may require further monitoring for apneic events. Upon discharge, non-opioid analgesia including acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) if age permits should be emphasized.

scholarly journals 668 Inguinal Hernia Repair: Are We Compliant with The Recommended Consent Process?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Barghash ◽  
T ElGhobashy ◽  
N Cheema ◽  
M Mansour
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Testicular Atrophy ◽  
Consent Process ◽  
Wound Complications ◽  
Local Policy ◽  
Patient Demographics ◽  
Retrospective Audit ◽  
The Uk

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.

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
Keyword(s):  
Diabetes Mellitus ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Repair ◽  
Testicular Atrophy ◽  
Predicting Factors ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Rheumatological Disease

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.

scholarly journals Testicular atrophy secondary to a large long standing incarcerated inguinal hernia

2011 ◽  
Vol 1 (3) ◽  
pp. 68
Author(s):  
Nikolaos S Salemis ◽  
Konstantinos Nisotakis
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Rare Case ◽  
Testicular Atrophy ◽  
Specific Group ◽  
Incarcerated Inguinal Hernia ◽  
Preoperative Work Up ◽  
Work Up ◽  
Scrotal Ultrasonography

Testicular atrophy is a rare but distressing complication of inguinal hernia repair. Apart from the postsurgical etiology, ischemic orchitis and subsequent testicular atrophy may occur secondary to compression of the testicular vessels by chronically incarcerated hernias. We present a rare case of testicular atrophy secondary to a large long standing incarcerated inguinal hernia of 2-decade duration in a 79-year-old man. Testicular atrophy should be always considered in long standing incarcerated inguinal hernias and patients should be adequately informed of this possibility during the preoperative work-up. Preoperative scrotal ultrasonography can be used to determine testicular status in this specific group of patients.

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