الفهرس 
Anatomy of the Inguinal RegionOnly 14 pages are availabe for public view
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Abstract
Background: About 10% of people develop some type of hernia during their lifetime. Hernias are seven times more common in males than in
females. It is reported that the overall current risk for a male to have an
inguinal hernia was 18%. Hernia repair is one of the commonest surgeries. The most effective method of repair of inguinal hernia is by means of a tension free technique involving the use of prosthetic mesh to reinforce the abdominal wall in the region of the groin. This can be accomplished by open or laparoscopic techniques; both repairs have been shown to offer faster recovery and lower recurrence rates than the traditional method. Over the evolution of treatments for inguinal hernia, it has been discovered that the use of prostheses is fundamental for obtaining low recurrence rates and high satisfaction rates.
Aim of the Work: this study aims to compare the effects of Prosthetic Mesh in laparoscopic and open inguinal hernia repair on testicular perfusion.
Patients and Methods: This study was conducted at Ain Shams University hospitals, from March 2017 to September 2019. Our study was a prospective randomized comparative study involving 40 patients suffering from inguinal hernia and in whom surgical management was indicated. Our patients were presented in the outpatients’ clinics, distributed randomly and divided using closed envelopment method into two groups: group (1): (20 patients) treated by the laparoscopic transabdominal and group (2): (20 patients) treated by the Lichtenstein hernia repair (LHR).
Results: there was highly statistically significant difference between the Testicular Volume at 1 and 3 days in the 2 groups (p<0.05). There was statistically significant difference between the Peak systolic velocity in the 2 groups at any time of follow-up (p<0.05). There was no statistically significant difference between the End diastolic velocity at 3 and 7 days in the 2 groups (p=0.72 and p= 0.85) respectively. While there was statistically significant difference between the End diastolic velocity at 1 days in the 2 groups (p=0.05). There was statistically significant difference between the Resistivity index in the 2 groups at any time of follow-up (p<0.05).
Conclusions: Open hernia had significantly lower of mean operative time, postoperative testicular volume, peak systolic velocity, postoperative end diastolic velocity, resistivity indexes compared lap hernia patients. Therefore, Mesh implantation/peri mesh fibrosis do not adversely affect the testicular arterial flow and the testicular perfusion, supporting the idea that inguinal mesh application is a safe procedure in male patients and Surgeons should be trained that all inguinal hernias should be repaired at diagnosis, even if asymptomatic. Giving information about the hernias and its complications should be more useful for the public.