Thursday, September 25, 2008

Can hernia repairs cause infertility?

The answer is yes.  Hernia repairs can result in damage to the vas deferens, the tube that carries sperm from the testicle to the outside world. 

How often this happens is not clearly known because:
  • Most hernias are unilateral, ie one sided only.
  • People who have hernia repairs are often beyond their child bearing years.
  • We don't routinely test sperm counts after hernia repairs.
Most hernia repairs are performed using a mesh that makes the hernia repair very strong and the patient's recovery pain free.  The reason that mesh is so good for hernia repairs is that it produces a very dense inflammatory reaction in the region of the hernia and the resultant scar prevents hernia recurrence. 

The inflammatory reaction also can damage the vas deferens.  More rarely, the vas can be injured by an errant clip or suture placement during the procedure. 

In any case, when I see a patient with azoospermia--no sperm--and 2 scars in their inguinal canals--groins--I think blockage.

Patients with azoospermia from hernia-induced blockages can be effectively treated.