Influence of inguinal hernia mesh repair on testicular flow and sperm autoimmunity.

BACKGROUND: The incidence of infertility caused by the mesh inguinal hernia repair is not known. The aim of this study was to determine circulation and immunological testicular disorders after inguinal hernia mesh repair which can be related with infertility. METHODS: From February 2010 to December 2010, 43 male patients who underwent inguinal hernia mesh repair were included in a prospective study. Testicular, capsular and intratesticular arterial flow dynamics were measured by Color Doppler ultrasound before the operation, in early and late postoperative period. The antisperm antibodies were analyzed before hernia repair and 5 months after. RESULTS: The difference between patients who underwent laparoscopic (Group I) and anterior open tension-free hernia repair (Group II) in age, duration of symptoms and hernia characteristics were not significant. Statistically significant differences were found in peak-systolic and end-diastolic velocity in testicular and intratesticular arteries in Group II and in peak-systolic velocity on all levels in Group I. Only Group I had significant differences in resistive index of intratesticular arteries. All the values returned to basal in late postoperative period except testicular peak-systolic velocity in Group I which stayed in normal range. Wilcox matched pair test showed significant difference between preoperative and late postoperative measurements of the antisperm antibodies only in Group II, but it was within normal range in all cases. CONCLUSIONS: Inguinal hernia mesh repair do not have clinically significant influence on testicular flow and immunological response.

[Permanent decrease in immune function in patients with splenectomy for trauma]. / Dugotrajno smanjena imuna funkcija kod pacijenata splenektomiranih zbog traume.

The authors describe the peripheral blood analyses in patients splenectomized for trauma in consideration on the concentration of the immunoglobulins total complement CH50 levels, T and B lymphocyte populations and compare this with the control group. The levels of the IgM were significantly decreased (p0.001) in splenectomised while the levels of the IgA and IgG were significantly increased (for IgA - p0.001, for IgG p0.01). Total lymphocyte count averaged 54501999 in splenectomized, with number of T cells 2463930 and B lymphocyte 460236. The control group showed total lymphocyte count 460236. The control group showed total lymphocyte count 520235 (p0.001) with number of T cells 314147 (p0.001) and number of B cells 7434 (p0.001), what is significantly less than in splenectomized population. The level of total complement CH50 in splenectomized population was 11216 (p0.01), what is significantly less than in the control group 12515. These data demonstrate persistent abnormalities in immune function and suggest a possible explantation for the increased rizu of sepsis in this group of patients.