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Bilateral endoscopic totally extraperitoneal (TEP) inguinal hernia repair does not impair male fertility

Hernia Sep 14, 2017

Roos MM, et al. - Authors performed this observational cohort study to assess fertility after bilateral endoscopic totally extraperitoneal (TEP) inguinal hernia repair in male patients. As per observations, bilateral endoscopic TEP hernia repair with polypropylene mesh did not affect fertility, as there appeared no differences in testicular blood flow, testicular volume, or semen quality. Despite significant differences between postoperative and preoperative levels of LH and inhibin B, no clinical relevance could be ascribed to these findings.


  • Authors identified 57 male patients (22–60 years old) with primary, reducible, bilateral inguinal hernias who underwent elective bilateral endoscopic TEP hernia repair with use of polypropylene mesh.
  • Testicular perfusion was primarily assessed; secondarily, they assessed testicular volume, endocrinological status, and semen quality.
  • Assessment of all patients was performed preoperatively and 6 months postoperatively.


  • In this study, 44 patients completed the follow-up.
  • Observations revealed no statistically significant differences in measurements of testicular blood flow parameters or testicular volume.
  • Significantly higher LH levels were observed postoperatively [preoperative median 4.3 IU/L (IQR 3.4–5.3) versus postoperative median 5.0 IU/L (IQR 3.6–6.5), p = 0.03].
  • Postoperatively, levels of inhibin B were significantly lower [preoperative median 139.0 ng/L (IQR 106.5–183.0) versus postoperative median 27.0 ng/L (IQR 88.3–170.9), p = 0.01].
  • There appeared no marked changes in FSH or testosterone levels.
  • No differences in semen quality were observed.

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