PMID- 10693689
OWN - NLM
STAT- MEDLINE
DCOM- 20000309
LR  - 20190710
IS  - 0022-3468 (Print)
IS  - 0022-3468 (Linking)
VI  - 35
IP  - 2
DP  - 2000 Feb
TI  - Testicular damage after surgical groin exploration for elective herniorrhaphy.
PG  - 327-30
AB  - BACKGROUND/PURPOSE: Controversy exists whether to explore the contralateral groin 
      in boys during unilateral herniorrhaphy. Proponents claim there is minimal risk 
      of injury to the cord structures and developing testicle with contralateral 
      exploration. However, findings have shown testicular atrophy occurred in 1% to 2% 
      of patients after herniorrhaphy, and vasal damage is possible after routine 
      manipulation of the spermatic cord. This study investigated the effect of routine 
      surgical exploration of the prepubertal groin on testicular development and 
      future fertility. METHODS: Twenty-four prepubertal Wistar rats were divided 
      equally into 2 groups. Group 1 (sham) rats underwent unilateral inguinoscrotal 
      incision only. Group 2 (experimental) rats underwent unilateral inguinoscrotal 
      exploration with manipulation of the cord structures as in human inguinal 
      exploration. At maturation, the fertility and fecundity of the males were 
      assessed. After mating, testes were examined for mass, volume, mean seminiferous 
      tubule diameter (MSTD), and mean testicular biopsy score (MTBS). The vasa were 
      examined for histological injury and vasal diameter. Statistical comparisons were 
      made by paired t test and Mann-Whitney rank sum test. RESULTS: There was a 
      difference between the volumes of the testes when comparing the operative and 
      nonoperative side of the 2 groups (experimental, deltavol = -0.063+/-0.123; sham, 
      deltavol = +0.067+/-0.137; P = .029). There also was a trend toward a smaller 
      testicular mass when comparing the two sides (experimental, deltamass = 
      -0.045+/-0.101; sham, Amass = +0.048+/-0.123; P = .057) but did not reach 
      significance. The MSTD and MTBS were similar between the ipsilateral and 
      contralateral testes in both groups. Likewise, the MSTD and MTBS were similar 
      when comparing the 2 groups. All male rats in both groups were fertile. The 
      number of offspring produced and the number of female rats impregnated were 
      similar between the 2 groups. There was no histological evidence of vasal injury 
      in any of the experimental spermatic cords. The vasal diameters were similar 
      between the 2 groups. CONCLUSION: Surgical manipulation of the prepubertal 
      spermatic cord imparts a small, but statistically significant morphological 
      change in testicular size without a deleterious effect on testicular development, 
      fertility, or fecundity.
FAU - Lee, S L
AU  - Lee SL
AD  - Department of Surgery, University of California, Davis, Medical Center, 
      Sacramento 95819, USA.
FAU - DuBois, J J
AU  - DuBois JJ
FAU - Rishi, M
AU  - Rishi M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Pediatr Surg
JT  - Journal of pediatric surgery
JID - 0052631
SB  - IM
MH  - Animals
MH  - Hernia, Inguinal/*surgery
MH  - Inguinal Canal/*surgery
MH  - Male
MH  - *Postoperative Complications
MH  - Rats
MH  - Rats, Wistar
MH  - Spermatic Cord/pathology
MH  - Testis/growth & development/*pathology
EDAT- 2000/02/29 09:00
MHDA- 2000/03/11 09:00
CRDT- 2000/02/29 09:00
PHST- 2000/02/29 09:00 [pubmed]
PHST- 2000/03/11 09:00 [medline]
PHST- 2000/02/29 09:00 [entrez]
AID - S0022-3468(00)90033-2 [pii]
AID - 10.1016/s0022-3468(00)90033-2 [doi]
PST - ppublish
SO  - J Pediatr Surg. 2000 Feb;35(2):327-30. doi: 10.1016/s0022-3468(00)90033-2.