Can laparoscopic hernia repair alter function and volume of testis? Randomized clinical trial

Testicular atrophy is a sequela of inguinal hernioplasty. The purpose of this study was to evaluate the effects of Lichtenstein (LHR) and laparoscopic totally extraperitoneal (TEP) hernia repair techniques on testicular function and volume. This study is a randomized prospective clinical trial with the blind assessment of outcome. A total of 26 patients who underwent elective herniorrhaphy for groin hernia were included in the study. Each patient was randomly assigned into one of two groups: either TEP or LHR (n = 13 for each). Six of the patients had bilateral hernia (n = 3 for each group). Luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone levels, and testicular volume by Doppler ultrasonography were detected just before and 3 months after the operation. LH, FSH levels did not change, when compared preoperative and postoperatively in both groups. Testicular volume and testosterone levels were observed to be significantly decreased after TEP when compared with LHR while no significant preoperative changes were observed between those groups. This affected the testicular volume in normal limits. TEP or LHR could not affect LH, FSH, testosterone values, but TEP could lead a decreasing effect on volume of testis in normal limits.