Table 1 Baseline characteristics of the included studies in the systematic review
Study (Author/Year) (Evidence level) | Country | Surgery | Design | Patients (n) | Mean age (years) | Mesh materials | Hernia side | Outcome measure | Follow-up (months) |
|---|---|---|---|---|---|---|---|---|---|
Bansal 2017 (I-1b) [13] | India | TAPP/TEP | RCT | TAPP 80 | TAPP 40.9 ± 12.3 | NS | Unilateral Hernia Bilateral hernia | Testicular functions Sexual functions | 3 |
VS TEP 80 | TEP 40 ± 12.5 | ||||||||
Krnić 2016 (III-3b) [14] | Croatia | Open | Case-control | Non-complicated hernia 57 VS Incarcerated hernia 64 | Group I 57 (40–81) | Bard® mesh | Right Hernia Left Hernia | Testicular blood flow | 5 |
Group II 64 (28–80) | |||||||||
Lal 2016 (III-3b) [15] | India | TEP | Self Case-control | 28 | 42.4 (18–72) | Bard 3DMax™ mesh | unilateral hernia (16 right sided and 8 left sided, 21 indirect and 3 direct hernias) and 4 to have bilateral hernia (2 direct and 2 indirect). | Resistive index | 3 |
Gvenetadze 2016 (III-3b) [16] | Georgia | Open | Case control | Lichtenstein 66 Gvenetadze method 149 | 19–40 | mesh | Bilateral | Oligospermia, reduction of the quantitative sperm | 1,6 |
Shkvarkovskiy 2015 (III-3b) [17] | Russian | Open | Case control | New method 61 | 19–61 | Polymeric mesh | Hernia | testicular arteries, testicular volume, sex hormones level. | NS |
Lichtenstein 63 | |||||||||
Yan 2015 (IV-4) [18] | China | Open | Retrospective study | 142 | 24.0 ± 2.0 | mesh | Unilateral | Infertility Sex function | 3–36 |
Khodari 2015 (IV-4) [19] | France | Open | Retrospective study | 69 | NS | polypropylene mesh | Bilateral (history of hernia repair) | Risk of infertility | NS |
Stula 2014 (II-2b) [27] | Croatia | TAPP/Open | Cohort study | TAPP 29 | 61(33–81) | Prolene mesh | Unilateral Bilateral | testicular blood flow (RI, PSV, EDV), ASA | 5–6 |
Open 53 | |||||||||
Peeters 2014 (I-1b) [28] | Belgium | TEP | RCT | Marlex ® 20 | 20–50 | (Marlex ®) VyproII ® TiMesh ® | Unilateral 39 Bilateral 20 | Semen analysis | 36 |
VyproII ® 20 | |||||||||
TiMesh ® 19 | |||||||||
Schouten 2012 (protocol) [29] | Netherlands | TEP | Cohort study | 21 | 18–60 | Prolene | Bilateral inguinal hernias | testicular perfusion and volume, semen quantity and quality endocrinological status | 6 |
Stula 2012 (II-2b) [30] | Croatia | TAPP/Open | Cohort | TAPP15 Open28 | 62(33–81) | Prolene mesh | Unilateral Bilateral | Testicular, capsular, intratesticular arterial flow dynamics | 5 |
Singh 2012 (I-1b) [31] | India | TAPP, TEP/Open | RCT | LAP (TAPP, TEP)60 Open 57 | LAP 45.7 ± 14.6 | mesh | Unilateral Bilateral | Testicular functions (testicular volume, blood flow, hormones) | 3 |
Open 45.4 ± 17.8 | |||||||||
Hallén 2012 (IV-4) [32] | Sweden | Open | retrospective | Open 34,267 | 23–62 | mesh | Unilateral Bilaterally | Risk for infertility | 12 |
No mesh | |||||||||
Skawran 2011 (III-3b) [33] | Germany | TEP | Case control | Light mesh group 21 | 18–60 | Bard TM soft mesh Bard TM flat mesh | Bilateral | Testicular volume and perfusion, serum levels of sexual hormones, ejaculate volume, and number of spermatic cells. | 3 |
Heavy group 38 | |||||||||
Hallén 2011 (III-3b) [34] | Sweden | NS | Case control | With mesh 232 | 18–55 | mesh/ without mesh | Bilateral(344) | Risk for infertility | NS |
Without mesh 112 | |||||||||
Control general 202 | |||||||||
Peeters 2010 (I-1b) [10] | Belgium | TEP | RCT | Marlex ® 20 | 20–50 | (Marlex ®) VyproII ® | Unilateral 39 Bilateral 20 | Semen analysis, scrotal ultrasonography | 12 |
VyproII ® 20 | TiMesh ® | ||||||||
TiMesh ® 19 | |||||||||
Sucullu 2010 (I-1b) [35] | Turkey | open | RCT | Lichtenstein 32 | LG 22 (20–28) | Polypropylene mesh | Unilateral | Testicular volume, resistive index Testicular function | 3 |
Mesh plug 32 | MPG 23 (20–30) | ||||||||
Kiladze 2009 (III-3b) [36] | Georgia | Open | Case control | Lichtenstein 56 | 44.8 | mesh | Bilateral | Main sperm parameters | 6 |
Modified Lichtenstein 61 | |||||||||
Chu 2009 (IV-4) [37] | USA | Open | Case series | 4 | NS | mesh | NS | Testicular atrophy | 6 |
Ramadan 2009 (III-3b) [38] | Turkey | Open | Case control | Indirect inguinal hernias 48 | 44.5 (30–73) | mesh | Unilateral direct inguinal hernia | testicular parenchyma, testicular arterial impedance, perfusion, venous flow | 2 |
Normal contralateral side 48 | |||||||||
Yamaguchi 2008 [39] (V-5) | Japan | Open | Case report | 1 | 30 | Polypropylene mesh | Bilateral herniorrhaphy | Hormonal testing Semen analyses Testicular size | 15 |
Brisinda 2008 (IV-4) [40] | Italy | Open | Case series | 26 | NS | mesh | Hernia tension free repair | testicular perfusion | 9 |
Dohle 2006 (V-5) [41] | Netherlands | open | Case report | 2 | 35 | Polypropylene mesh | Unilateral Bilateral | Semen analysis | 3 |
Langenbach 2006 (I-1b) [42] | Germany | TAPP | RCT | Monofile, heavy-weight, rigid mesh 30 Smooth, heavy-weight variant of polypropylene 30 Polyglactin/polypropylene compound mesh 30 | 35–75 | Rigid mesh Polypropylene Polyglactin/polypropylene | Unilateral | Testicular volume | 3 |
Shin 2005 (IV-4) [9] | USA | LAP/Open | Case series | 12 LAP 2 Open+ LAP | 35.5 (28–42) | Polypropylene mesh | Unilateral Bilateral | Zaoospermia | 6–36 |
Nagler 2005 (V-5) [43] | USA | Open | Case report | 1 | 45 | Polypropylene mesh | Right and left herniorrhaphy | Fructose-positive azoospermia | 72 |
Akbulut 2003 (I-1b) [44] | Turkey | TEP / LHR | RCT | LHR 13 TEP 13 | TEP 46.7 ± 1.7 LHR 54.2 ± 2.6 | Polypropylene mesh | Unilateral Bilateral | Testicular function and volume | 12 |
Aydede 2003 (I-1b) [45] | Turkey | Open | RCT | Posterior preperitoneal mesh repair 30 Anterior tension-free repair 30 | 22 > 60 38 < 60 | mesh | Unilateral | Testicular flow spermatogenesis | 2.5 |
Yang 1997 (V-5) [46] | China | Open (when child) | Case report | 3 | 30/31/50 | No mesh | Unilateral Bilateral | Obstructive azoospermia | 30 year |