Factors that predict testicular atrophy in patients who underwent inguinal hernia repair


  • Faraj Afandiyev Department of Urology, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey
  • Haydar Celasin Department of General Surgery, Faculty of Medicine, Lokman Hekim University, Ankara, Turkey
  • Serdar Culcu Department of Surgical Oncology, SBU Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara




Testicular atrophy, Totally extraperitoneal procedures, Inguinal hernia, Erectile function


Background: Some of the patients that undergo inguinal hernia repair develop testicular atrophy. Testicular atrophy development also brings about a lot of problems. In our study, we aimed to determine the rate of development of testicular atrophy and predicting factors in patients that undergo inguinal hernia repair in our hospital.

Methods: Patients who underwent inguinal hernia repair in our centre from January 2017 to January 2020 were included in our study. Total number of patients was 158 divided into 2 groups i.e. group-1 (those who developed testicular atrophy after inguinal hernia repair) and group-2 (those who did not develop testicular atrophy after inguinal hernia repair). We investigated the relationship between the development of testicular atrophy and age, hernia type and localization, duration of surgery and anesthesia, perioperative non-steroidal anti-inflammatory drugs (NSAID) and antispasmolytic use, diabetes mellitus and rheumatological disease and, perioperative fluid replacement.

Results: Testicular atrophy developed in 6 of the patients (3.79%). We found that testicular atrophy was mostly secondary and mostly visible in cases underwent open repair (p=0.0001); and in which left and bilateral inguinal hernia repair was performed (p=0.014); and in cases with DM and rheumatological diseases (p=0.0001). We also found that the use of perioperative antispasmolytic and NSAID was lower in patients with testicular atrophy (p=0.0001).

Conclusions: According to the results of our study, advanced age, secondary and open repair, diabetes mellitus, rheumatological disease history, not using antispasmolytic and NSAID increases the risk of testicular atrophy.


Jenkins JT, O'Dwyer PJ. Inguinal hernias. BMJ. 2008;336:269-72.

Hall MJ, Schwartzman A, Zhang J, Liu X. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Rep. 2017;102:1-5.

Devlin HB. Trends in hernia surgery in the land of Astley Cooper. In: Soper NJ (ed) Problems in general surgery. Lippincott Raven, Philadelphia. 1995;12:85-92.

Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362:1561-71.

Haskell DL, Sunshine B, Heifetz CJ. A study of bladder catheterization with inguinal hernia operations. Arch Surg. 1974;109:378-80.

Goldman G, Leviav A, Mazor A, Kashtan H, Aladgem D, Greenstein A, et al. Alpha-adrenergic blocker for posthernioplasty urinary retention. Prevention and treatment. Arch Surg. 1988;123:35-6.

Reid I, Devlin HE. Testicular atrophy as a consequence of inguinal hernia repair. Br J Surg. 1994;81:91-3.

Zieren J, Beyersdorff D, Beier KM, Muller JM. Sexual function and testicular perfusion after inguinal hernia repair with mesh. Am J Surg. 2001;181:204-6.

Singh AN, Bansal VK, Misra MC, Kumar S, Rajeshwari S, Kumar A, Sagar R, Kumar A.

Testicular functions, chronic groin pain, and quality of life after laparoscopic and open mesh repair of inguinal hernia: a prospective randomized controlled trial. Surg Endosc. 2012;26(5):1304-17.

Akbulut G, Serteser M, Yucel A, Degirmenci B, Yilmaz S, Polat C, San O, Dilek ON . Can laparoscopic hernia repair alter function and volume of testis? Randomized clinical trial. Surg Laparosc Endosc Percutan Tech. 2003;13:377-81.

Wantz GE. Testicular Atrophy as a sequela of inguinal hernioplasty. Int Surg. 1986;71:159-63.






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