[Testicular atrophy. A risk of inguinal hernioplasty]

Testicular atrophy is a complication of inguinal hernioplasty that angers men of all ages. It is caused by thrombosis of the spermatic cord. Experience with over 6,500 inguinal hernioplasties in men indicates that the thrombosis is induced by direct surgical trauma to the cord. Trauma to the cord can be minimized and the incidence of testicular atrophy can be reduced by 1) not dissecting beyond the pubic tubercle, by 2) leaving distal indirect hernia sacs attached to the cord or by 3) avoiding dissection of the spermatic cord altogether by employing a posterior properitoneal approach.