ORIGINAL PAPER
Analysis of volume change of the testis after inguinal hernia repair using the PIRS method – a prospective pilot study
1
Collegium Medicum, Jan Kochanowski University, Kielce, Poland Head of the Collegium: Prof. Marianna Janion MD, PhD
2
Department of Paediatric Surgery, Urology, and Traumatology, Provincial Hospital, Kielce, Poland Head of the Department: Przemysław Wolak MD, PhD
3
Department of Paediatric Radiology, Provincial Hospital, Kielce, Poland Head of the Department: Piotr Cierniak MD, PhD
4
Department of Internal Disease, City Hospital of Zabrze, Zabrze, Poland Head of the Department: Włodzimierz Pokrzywnicki MD, PhD
Submission date: 2021-12-28
Acceptance date: 2022-04-06
Publication date: 2022-06-30
Medical Studies 2022;38(2):124-131
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Laparoscopic surgery of inguinal hernias in children using the PIRS method is a recognized method of treatment that has been used for several years.
Aim of the research:
To assess the effects of inguinal hernia repair performed with the percutaneous inguinal ring suturing (PIRS) method on the volume of the testicles.
Material and methods:
It was a prospective study conducted between January 2016 and December 2019 in the Department of Paediatric Surgery. Twenty-nine male patients aged 0–8 years were included in the study. Ultrasound evaluation of both testicles, comparing the volume before and after inguinal hernia repair, was performed.
Results and conclusions:
The ultrasound measurements of the testicular volume after the surgical procedure showed no inhibition of growth with the preoperative sonographic examination and concerning the testis of the opposite, non-operated side. The increase in the median of the volume of both testis’ was observed in cases before and after the elective surgeries, although there was no statistically significant difference. Emergency operation due to the incarcerated hernia on either side did not statistically significantly affect testicular volume in the tested group of patients. None of the laparoscopically operated patients showed atrophy of the testis. Laparoscopic surgery using the PIRS method in the case of inguinal hernia does not result in testicular atrophy or a decrease of the volume of the testis on the operated side.
Laparoscopic surgery of inguinal hernias in children using the PIRS method is a recognized method of treatment that has been used for several years.
Aim of the research:
To assess the effects of inguinal hernia repair performed with the percutaneous inguinal ring suturing (PIRS) method on the volume of the testicles.
Material and methods:
It was a prospective study conducted between January 2016 and December 2019 in the Department of Paediatric Surgery. Twenty-nine male patients aged 0–8 years were included in the study. Ultrasound evaluation of both testicles, comparing the volume before and after inguinal hernia repair, was performed.
Results and conclusions:
The ultrasound measurements of the testicular volume after the surgical procedure showed no inhibition of growth with the preoperative sonographic examination and concerning the testis of the opposite, non-operated side. The increase in the median of the volume of both testis’ was observed in cases before and after the elective surgeries, although there was no statistically significant difference. Emergency operation due to the incarcerated hernia on either side did not statistically significantly affect testicular volume in the tested group of patients. None of the laparoscopically operated patients showed atrophy of the testis. Laparoscopic surgery using the PIRS method in the case of inguinal hernia does not result in testicular atrophy or a decrease of the volume of the testis on the operated side.
REFERENCES (29)
1.
Esposito C, Escolino M, Cortese G, Aprea G, Turrà F, Farina A, Roberti A, Cerulo M, Settimi A. Twenty-year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs. Surg Endosc 2017; 31: 1461-1468.
2.
Shalaby R, Ismail M, Samaha A, Yehya A, Ibrahem R, Gouda S, Helal A, Alsamahy O. Laparoscopic inguinal hernia repair; experience with 874 children. J Pediatr Surg 2014; 49: 460-464.
3.
Montupet P, Esposito C. Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure. Surg Endosc 2011; 25: 450-453.
4.
Gibbons AT, Hanke RE, Casar Berazaluce AM, Abdulhai S, Glenn IC, McNinch NL, Endo M, Shah S, Yada K, Wo- lak P, Leys CM, Aranda A, Miyano G, Midulla P, Patkowski D, Novotny NM, Ponsky TA. Recurrence after laparoscopic high ligation in adolescents: a multicenter international retrospective study of ten hospitals. J Pediatr Surg 2021; 56: 126-129.
5.
Wolak PK, Strzelecka A, Piotrowska A, Dąbrowska K, Wolak PP, Piotrowska I, Nowak-Starz G. The operative time for unilateral inguinal hernia repair in children performed with percutaneous internal ring suturing (PIRS) or open approach method. J Clin Med 2021; 10: 1293.
6.
Patkowski D, Chrzan R, Jaworski W, Apoznański W, Czernik J. Percutaneous internal ring suturing for inguinal hernia repair in children under three months of age. Adv Clin Exp Med 2006; 15: 851-856.
7.
Patkowski D, Czernik J, Chrzan R, Jaworski W, Apoznański W. Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech 2006; 16: 513-517.
8.
Wolak PK, Patkowski D. Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique – own experience. Videosurgery Miniinv 2014; 9: 53-58.
9.
Sonderman KA, Wolf LL, Armstrong LB, Taylor K, Jiang W, Weil BR, Koehlmoos TP, Ricca RL, Weldon CB, Haider AH, Rice-Townsend SE. Testicular atrophy following inguinal hernia repair in children. Pediatr Surg Int 2018; 34: 553-560.
10.
Puri P, Guiney EJ, O’Donnell B. Inguinal hernia in infants: the fate of the testis following incarceration. J Pediatr Surg 1984; 19: 44-46.
11.
Esposito C, Turial S, Alicchio F, Enders J, Castagnetti M, Krause K, Settimi A, Schier F. Laparoscopic repair of incarcerated inguinal hernia. A safe and effective procedure to adopt in children. Hernia 2013; 17: 235-239.
12.
Orth RC, Towbin AJ. Acute testicular ischemia caused by incarcerated inguinal hernia. Pediatr Radiol 2012; 42: 196-200.
13.
Dandapat MC, Padhi NC, Patra AP. Effect of hydrocele on testis and spermatogenesis. Br J Surg 1990; 77: 1293-1294.
14.
Gürbulak EK, Gürbulak B, Akgün İE, Özel A, Akan D, Ömeroğlu S, Öz A, Mihmanlı M, Bektaş H. Effects of totally extraperitoneal (TEP) and Lichtenstein hernia repair on testicular blood flow and volume. Surgery 2015; 158: 1297-1303.
15.
Mihmanli I, Kantarci F, Kulaksizoglu H, Gurses B, Ogut G, Unluer E, Uysal O, Altug A. Testicular size and vascular resistance before and after hydrocelectomy. Am J Roentgenol 2004; 183: 1379-1385.
16.
Ersin S, Aydin U, Makay O, Icoz G, Tamsel S, Sozbilen M, Killi R. Is testicular perfusion influenced during laparoscopic inguinal hernia surgery? Surg Endosc 2006; 20: 685-689.
17.
Parelkar SV, Oak S, Bachani MK, Sanghvi B, Prakash A, Patil R, Sahoo S, Patel J. Laparoscopic repair of pediatric inguinal hernia: is vascularity of the testis at risk? A study of 125 testes. J Pediatr Surg 2011; 46: 1813-1816.
18.
Leung WY, Poon M, Fan TW, Siu KW, Chung KW, Kwok WK, Kwok CH. Testicular volume of boys after inguinal herniotomy: combined clinical and radiological follow-up. Pediatr Surg Int 1999; 15: 40-41.
19.
Adaletli I, Kurugoglu S, Kantarci F, Tireli GA, Yilmaz MH, Gulsen F, Mihmanli I, Sander S. Testicular volume before and after hydrocelectomy in children. J Ultrasound Med 2006; 25: 1131-1136.
20.
Palabiyik FB, Cimilli T, Kayhan A, Toksoy N. Do the manipulations in pediatric inguinal hernia operations affect the vascularization of testes? J Pediatr Surg 2009; 44: 788-790.
21.
Schier F, Turial S, Hückstädt T, Klein KU, Wannik T. Laparoscopic inguinal hernia repair does not impair testicular perfusion. J Pediatr Surg 2008; 43: 131-135.
22.
Tuncer AA, Peker T, Acar MB, Embleton DB, Cetinkur- sun S. A comparison of preoperative and postoperative testicular volume and blood flow in patients with inguinal hernia, hydrocele, and cord cyst: a prospective cohort study. Pak J Med Sci 2017; 33: 363-368.
23.
Ozdamar MY, Karakus OZ. Testicular ischemia caused by incarcerated inguinal hernia in infants: incidence, conservative treatment procedure, and follow-up. Urol J 2017; 14: 4030-4033.
24.
Houben CH, Chan KWE, Mou JWC, Tam YH, Lee KH. Irreducible inguinal hernia in children: how serious is it? J Pediatr Surg 2015; 50: 1174-1176.
25.
Turgut AT, Ünsal A, Özden E, Kosar P, Kosar U, Emir L. Unilateral idiopathic hydrocele has a substantial effect on the ipsilateral testicular geometry and resistivity indices. J Ultrasound Med 2006; 25: 837-843.
26.
Mbibu NH, Maitama HY, Ameh EA, Khalid LM, Adams LM. Acute scrotum in nigeria: an 18-year review. Trop Doct 2004; 34: 34-36.
27.
Mishra PK, Burnand K, Minocha A, Mathur AB, Kulkar- ni MS, Tsang T. Incarcerated inguinal hernia management in children: ‘a comparison of the open and laparoscopic approach. Pediatr Surg Int 2014; 30: 621-624.
28.
Gökçora IH, Yagmurlu A. A longitudinal follow-up using the high trans-scrotal approach for inguinal and scrotal abnormalities in boys. Hernia 2003; 7: 181-184.
29.
Chen LE, Zamakhshary M, Foglia RP, Coplen DE, Lan- ger JC. Impact of wait time on outcome for inguinal hernia repair in infants. Pediatr Surg Int 2009; 25: 223-227.
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| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
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