Testicular damage after surgical groin exploration for elective herniorrhaphy

Area of Science:

• Pediatric Surgery
• Reproductive Biology
• Spermatic Cord Anatomy

Background:

• Controversy exists regarding routine contralateral groin exploration during unilateral herniorrhaphy in boys.
• Concerns include potential injury to cord structures and developing testicles, with reported testicular atrophy and vasal damage.
• This study investigates the impact of surgical manipulation on testicular development and fertility.

Purpose of the Study:

• To evaluate the effect of routine surgical exploration of the prepubertal spermatic cord on testicular development and future fertility.
• To determine if contralateral groin exploration during herniorrhaphy poses a risk to testicular health.

Main Methods:

• Prepubertal Wistar rats were divided into experimental (unilateral exploration) and sham (incision only) groups.
• Fertility and fecundity were assessed at maturation.
• Testes were examined for mass, volume, mean seminiferous tubule diameter (MSTD), and mean testicular biopsy score (MTBS).
• Vasa were assessed for histological injury and diameter.

Main Results:

• A statistically significant difference in testicular volume was observed between operative and nonoperative sides in the experimental group.
• No significant difference in testicular mass was found.
• Mean seminiferous tubule diameter and mean testicular biopsy score were similar between groups and sides.
• All male rats were fertile with similar reproductive outcomes.
• No histological evidence of vasal injury was detected.

Conclusions:

• Surgical manipulation of the prepubertal spermatic cord results in a minor, statistically significant change in testicular size.
• This morphological change does not adversely affect testicular development, fertility, or fecundity.
• Findings suggest routine contralateral exploration may be safe in prepubertal boys undergoing herniorrhaphy.