ArticleBMC surgery2012
Male infertility after endoscopic Totally Extraperitoneal (Tep) hernia repair (Main): rationale and design of a prospective observational cohort study.
Article in BMC surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- TEP for elective primary unilateral inguinal hernia repair in men: what do we know?Hernia : the journal of hernias and abdominal wall surgery · 2019Pooled it
- Does the use of hernia mesh in surgical inguinal hernia repairs cause male infertility? A systematic review and descriptive analysis.Reproductive health · 2018Pooled it
- International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018Guideline
- Incarcerated Inguinal Hernia Mesh Repair: Effect on Testicular Blood Flow and Sperm Autoimmunity.Medical science monitor : international medical journal of experimental and clinical research · 2016Trial
- Beyond acronyms: a domain-based structural analysis of abdominal wall hernia repair techniques in the contemporary literature.Surgical endoscopy · 2026Article
- How Reproducible Are Abdominal Wall Surgical Techniques? A Methodological Assessment of Technical Reporting in the Contemporary Literature.Journal of abdominal wall surgery : JAWS · 2026Article
- Laparoscopic Inguinal Hernioplasty with a Polyether Ether Ketone Anchoring Device in Intact Male Horses Does Not Compromise Testicular Perfusion, Sperm Production or Motility Characteristics.Animals : an open access journal from MDPI · 2025Article
- High ligation of the hernia sac in open nonmesh inguinal herniorrhaphy is an important cause of iatrogenic vas deferens injury.Asian journal of andrology · 2023Article
- Bilateral endoscopic totally extraperitoneal (TEP) inguinal hernia repair does not impair male fertility.Hernia : the journal of hernias and abdominal wall surgery · 2017Observational
- Crossover transseptal vasovasostomy: alternative for very selected cases of iatrogenic injury to vas deferens.International braz j urol : official journal of the Brazilian Society of UrologyArticle
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo describe the rationale and design of an observational cohort study analyzing the effects of endoscopic Totally Extraperitoneal (TEP) hernia repair on male fertility (MAIN study). METHODS AND
designThe MAIN study is an observational cohort study designed to assess fertility after endoscopic TEP hernia repair. The setting is a high-volume single center hospital, specialized in TEP hernia repair. Male patients of 18-60 years of age, with primary, reducible, bilateral inguinal hernias and no contraindications for endoscopic TEP repair are eligible for inclusion in this study. Patients with an ASA-classification≥III and patients with recurrent and/or scrotal hernias and/or a medical history of pelvic surgery and/or radiotherapy, known fertility problems, diabetes and/or other diseases associated with a risk of fertility problems, will be excluded. The primary outcome is the testicular perfusion before and 6 months after TEP hernia repair (assessed by means of a scrotal ultrasonography). Secondary endpoints are the testicular volume (Ultrasound), semen quality and quantity and the endocrinological status, based on serum levels of the sexual hormones follicle-stimulating hormone (FSH), luteinizing hormone (LSH), testosterone and inhibin B before and 6 months after TEP hernia repair. DISCUSSION: The use of polypropylene mesh is associated with a strong foreign body reaction which could play a role in chronic groin pain development. Since the mesh in (endoscopic) inguinal hernia repair is placed in close contact to the vas deferens and spermatic vessels, the mesh-induced inflammatory reaction could lead to a dysfunction of these structures. Relevant large and prospective clinical studies on the problem are limited. This study will provide a complete assessment of fertility in male patients who undergo simultaneous bilateral endoscopic TEP hernia repair, by analyzing testicular perfusion and volume, semen quantity and quality and endocrinological status before and 6 months after TEP repair.
trial registrationThe MAIN study is registered in the Dutch Trial Register (NTR2208).
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