Is inguinal hernia repair safe for testicular atrophy? Our 10 year results

Background: We aimed to determine the incidence and predictors of testicular atrophy (TA) in patients undergoing inguinal hernia repair at our hospital. Methods: The total patient number is 578.The patients were divided Group-1 (developed testicular atrophy) and Group-2 (did not develop testicular atrophy). The testicles were evaluated with Scrotal Color Doppler Ultrasonography (SCDU) in preoperative and postoperative third month. Results: Median age in the Group - 1 and Group - 2 respectively is 64,0 ± 12,3 (47-81 ) and 48,9 ± 17,4 (18-89) (p =0.037). TA developed in 5.01% (29/578) of the patients. We determined that TA developed more often in the patients who are over the age of 40 (p=0.007), in secondary cases (p<0.001), in  open repair (p<0.001), those who do not use perioperative narcotic and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)(p<0.001), those who use perioperative antispasmodic drugs (p=0.017), those having a rheumatic disease(RD) and  diabetes mellitus(DM) (p<0.001).Results of multivariate analysis, testicular atrophy development increases when perioperative NSAID is not used ( OR:13.24; 95% CI:4.19-41.87; P<0.001) , perioperative narcotic is not applied (OR:13.91; 95% CI:4.35-44.55; P <.001) and RD exists (OR:0.10; 95%CI:0.03-.35; P<0.001). Conclusions: Advanced age, DM and rheumatic disease, not using perioperative NSAIDs, narcotic drugs and antispasmodic drugs increases the risk of testicular atrophy.