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Erectile Function Before and After Elective Inguinal Hernia Repair: A Paired IIEF-5 Study Comparing Laparoscopic and
Volkan Sayur1, Mehmet Avcı1, Erkan Güler2
1Department of Surgery, School of Medicine, Ege University, İzmir 35080, Turkey.
Journal of Clinical Medicine
|June 26, 2026
Summary
Erectile function is generally preserved after inguinal hernia repair, with a small but significant increase in International Index of Erectile Function-5 (IIEF-5) scores post-surgery. Scrotal hernias and lower baseline IIEF-5 scores may predict greater improvement.
Area of Science:
- Urology
- Surgical Sciences
- Men's Health
Background:
- Inguinal hernia repair is a common surgical procedure in men.
- Erectile function is a critical aspect of men's health that may be impacted by surgical interventions.
- Understanding the impact of different surgical techniques on erectile function is important for patient counseling and outcomes.
Purpose of the Study:
- To evaluate changes in erectile function, using the International Index of Erectile Function-5 (IIEF-5), after elective inguinal hernia repair.
- To compare erectile function outcomes between laparoscopic and open Lichtenstein repair techniques.
- To identify predictors of postoperative changes in erectile function.
Main Methods:
- A cohort of 126 male patients undergoing elective unilateral inguinal hernia repair (laparoscopic or open Lichtenstein) was studied.
- Erectile function was assessed using the IIEF-5 questionnaire preoperatively and at six months postoperatively.
- Subgroup analyses included scrotal hernia presence; multivariate regression identified predictors of IIEF-5 score changes.
Main Results:
- Overall mean IIEF-5 scores showed a statistically significant increase from 22.85 preoperatively to 23.35 postoperatively (p < 0.05).
- No significant difference in IIEF-5 score change was found between laparoscopic and open repair groups (p > 0.05).
- Patients with scrotal hernias exhibited a greater IIEF-5 score increase (p < 0.001); lower baseline IIEF-5 and scrotal hernia status predicted greater improvement.
Conclusions:
- Erectile function is largely preserved after elective inguinal hernia repair, with a small but significant overall improvement in IIEF-5 scores.
- Laparoscopic and open Lichtenstein repairs yielded similar changes in erectile function.
- Scrotal hernia presence and lower baseline erectile function scores may be associated with greater postoperative improvement, warranting further prospective research.
