Ultrassonographic evaluation of testicle of patients submitted to bilateral inguinal hernioplasty: comparative clinical trial between Lichtenstein and Laparoscopic techniques

Abstract

The hernia inguinal repair has changed considerably over the past 15 years. The use of meshes for repair reduced recurrence rates, post-operative pain and facilitating the return of activities however, concern for testicular function and fertility had increased. The main advantages of laparoscopy compared to open surgery are the shorter hospital stay, early return to activity and lower incidence of chronic pain and numbness. However, with respect to the effects of hernia repair on testicular function, the data available in the literature remain uncertain, regardless of the technique used. Thus, this study aims to evaluate the ultrasound aspects of the testis of patients undergoing bilateral herniorrhaphy. For this purpose, a randomized clinical trial will be performed in which the Lichtenstein and Laparoscopic techniques will be compared, in patients aged between 20 and 60 years, with primary and reducible bilateral inguinal hernia. Exclusion criteria will be: ASAeIII patients, history of testicular disease or trauma, diseases that may develop with infertility, fertility or sexual problems, history of pelvic surgery or radiotherapy, presence of recurrent, incarcerated, femoral or inguine-scrotal hernia, use of gonadotropins or anabolic steroids. In all cases, the polypropylene mesh will be used. The types of hernia will be classified intraoperatively according to the Nyhus classification. Intraoperative complications and the total procedure time will be recorded. The USG of testicle will be performed in two stages: in the preoperative period (day of surgery) and 90 days after surgery. Doppler USG will assess testicular perfusion by measuring the blood flow velocity (cm / s) of the testicular, capsular and intratesticular arteries.